Clinical Assessment of Open Flap Debridement Using Magnifying Loupes and Surgical Operating Microscope: A Split-Mouth Randomized Controlled Clinical Trial

Jaswitha Vintha; Mohan Kumar Pasupuleti; Gautami Subhadra Penmetsa; Sruthima Naga Venkata  Satya Gottumukkala; Ramesh Santosh Venkata Konathala; Santosh Vamsi Eagala

doi:10.18502/fid.v22i31.19399

Jaswitha Vintha Department of Periodontics and Implantology, Vishnu Dental College, Dr. NTR University of Health Sciences, Bhimavaram, India
Mohan Kumar Pasupuleti Department of Periodontics and Implantology, Vishnu Dental College, Dr. NTR University of Health Sciences, Bhimavaram, India
Gautami Subhadra Penmetsa Department of Periodontics and Implantology, Vishnu Dental College, Dr. NTR University of Health Sciences, Bhimavaram, India
Sruthima Naga Venkata Satya Gottumukkala Department of Periodontics and Implantology, Vishnu Dental College, Dr. NTR University of Health Sciences, Bhimavaram, India
Ramesh Santosh Venkata Konathala Department of Periodontics and Implantology, Vishnu Dental College, Dr. NTR University of Health Sciences, Bhimavaram, India
Santosh Vamsi Eagala Department of Periodontics and Implantology, Vishnu Dental College, Dr. NTR University of Health Sciences, Bhimavaram, India

DOI: https://doi.org/10.18502/fid.v22i31.19399

Keywords: Debridement; Minimally Invasive Surgical Procedures; Surgical Flaps

Abstract

Objectives: To overcome the drawbacks of the conventional flap surgery, newer surgical techniques like minimally invasive surgery were evolved to optimize the primary closure of the flap. Using a surgical operating microscope is one such technique, enhancing precession with clinical benefits. The current study aimed to compare the efficacy of a surgical operating microscope versus surgical loupes regarding periodontal treatment outcomes.

Materials and Methods: In this split-mouth randomized controlled clinical trial, flap surgery was planned for sites with a pocket probing depth (PPD)≥5mm under a surgical operating microscope and surgical loupes. All clinical periodontal parameters were recorded at baseline, and 3, and 6 months. The patients’ perception of postoperative pain and wound healing were also assessed.

Results: The study comprised of 20 participants with mild to severe periodontitis. The reduction in the mean PPD was significantly greater at the test site than the control site at 3 months (P=0.05) and 6 months (P=0.005). At 3 months, there was a statistically significant difference in clinical attachment level (CAL) between the test and control sites (P=0.001). Flap surgery performed under a surgical operating microscope significantly enhanced early wound healing and caused less postoperative pain compared to flap surgery performed under surgical loupes (P<0.05).

Conclusion: All parameters improved at the test and control sites after the procedure. Nonetheless, the clinical parameters were noticeably better at the test site. Also, the test site had lower postoperative pain and enhanced wound healing compared with the test site.