The papilla amplification flap for the treatment of a localized periodontal defect associated with a palatal groove

Background: Teeth with a palatal groove often present with severe localized periodontal attachment loss including pocket formation and alveolar bone loss. The aim of the present case report was to describe the regenerative surgical treatment of periodontal and bone lesions associated with the subgingival extension of palatal groove affecting a maxillary lateral incisor. Methods: The left maxillary lateral incisor of a systemically healthy young subject presented with a palatal probing depht of 10 mm with no gingival recession at the buccal and palatal surfaces; the neighbouring interdental papillae were intact. The radiograph showed a translucency area distal to the affected tooth. Treatment procedures consisted of: 1) the papilla amplification flap with the use of enamel matrix proteins as the regenerative periodontal material; 2) the elimination/flattening of the radicular portion of the palatal groove; 3) the sealing of the coronal portion of the groove with composite flow. Results: The clinical examination at 1 year revealed a clinical attachment gain (8mm) with a shallow residual probing depht (2mm) and no increase in gingival recession. The radiographic examination showed a complete disappearance of the radiolucency area suggesting bone fill. Conclusions: The present study indicated that localized periodontal defects associated with a palatal groove can be successfully threated by means of the papilla amplification flap with the use of enamel matrix protein as the regenerative material. The long-term stability of such successfull results needs to be determined.