Comparative Evaluation of Single-Flap Approach and Open-Flap Debridement with Calcium Phosphosilicate Bone Graft in the Treatment of Intrabony Defects: A Clinico-Radiographic Study.

Background: Periodontal intrabony defects pose a significant therapeutic challenge in periodontitis management. The single-flap approach (SFA) is a minimally invasive alternative to conventional open-flap debridement (OFD), aiming to improve healing outcomes and reduce surgical trauma. Aim: To compare the clinical and radiographic outcomes of SFA and OFD, both combined with calcium phosphosilicate (CPS) bone graft in the treatment of intrabony defects. Materials and Methods: This randomized clinical trial included 24 systemically healthy patients with chronic periodontitis and comparable intrabony defects. Patients were allocated into two groups: Group A (SFA + CPS putty) and Group B (OFD + CPS putty). Clinical parameters, including plaque index (PI), gingival index (GI), oral hygiene index-simplified (OHI-S), probing pocket depth (PPD), and relative attachment level (RAL), were measured at baseline, 3, 6, 9, and 12 months. Radiographic assessment using CBCT was conducted at baseline and 12 months to determine percentage bone fill. Results: Both techniques resulted in significant improvements. However, SFA showed superior reductions in PPD and better clinical attachment gain. Radiographically, the SFA group demonstrated significantly greater bone fill at 12 months (P = 0.043). Conclusion: SFA combined with CPS graft provides a less invasive and effective alternative to OFD, offering enhanced clinical outcomes and faster healing.