Endoscope-assisted Flapless Approach Versus Papillary Preservation Technique in Periodontal Regeneration.

Inclusion criteria

• Stage III - Stage IV Periodontitis patients, 3-4 months after completing steps I & II periodontal therapy.
• At least 1 tooth presented with 1 site with >5mm residual PPD and ≥6mm CAL, with ≥3mm intra-osseous defect presented involving predominantly the interdental space of the tooth and presented on paralleling periapical radiographs and/or CBCT.
• Presence of a periodontally stable tooth with PPD≤3mm immediate adjacent to the intra-bony defect of the investigated tooth
• Good Oral Hygiene, with Full Mouth Plaque Score ≤25% at baseline and with good plaque control at proposed surgical field.

Exclusion criteria

• Pre-study period

• Any systemic condition which prevents following the study protocol;
• Any systemic condition which may affect healing outcomes of patients, e.g. uncontrolled or poorly controlled diabetes, unstable or life-threatening conditions or those requiring antibiotic prophylaxis;
• Patients under long-term analgesic medication;
• Current smokers;
• Self-reported pregnancy;
• Systemic antimicrobial therapy within 3 months;
• Teeth that concurrently present with a buccal and a lingual intrabony defect component;
• Tooth with hopeless prognosis or questionable prognosis associated with endodontic lesions, or subgingival restorations that preclude clinical measurements, or excessive uncontrolled mobility;
• Any factors which prohibit regular performance of plaque control around surgical sites;
• Inadeduate oral hygiene with full mouth plaque score >25%
• Furcation involved surfaces
• During study period -Non-compliance with study protocol