Minimally-Invasive Non-Surgical Therapy of Intrabony Defects: Prospective Cohort Multicentre Study

Objectives: A minimally-invasive non-surgical treatment protocol (MINST) has been proposed for the treatment of periodontitis in order to minimise patient discomfort and maximise healing potential. Few studies have been published on MINST and no data is available on the generalisability of this novel approach for the treatment of intrabony defects. Aim: To assess clinical and radiographic outcomes of intrabony defects treated with MINST. Methods: This is a preliminary report on the first 20 patients included in a prospective multicentre cohort study on intrabony defects ≥3 mm treated with MINST in non-smokers in private practices in the UK and Italy. Sub-papillary access to the defect was carried out to minimise trauma to the soft tissues. Clinical and radiographic data were analysed at baseline and 12 months after treatment. The primary outcome of the study is radiographic defect depth reduction at 12 months, while secondary outcomes are probing pocket depth (PPD) and clinical attachment level (CAL) change. Results: Average PPD and CAL of included defects at baseline were 8.4 mm and 9.1 mm respectively, while the radiographic intrabony component was 6.44 mm. Fifteen defects achieved ‘pocket closure’ (PPD ≤ 4mm) at 12 months. However, only half of the cases (n=10) achieved resolution when a composite outcome of PPD ≤ 4mm and CAL gain ≥3 mm was considered. PPD, CAL and overall radiographic bone defect significantly improved between baseline and 12 months at repeated ANOVA (p< 0.05). The average radiographic intrabony defect depth reduced by 0.99 mm (p =0.077), with narrower and deeper defects associated with greater intrabony defect depth reduction. Conclusions: This preliminary analysis shows improvements in clinical and radiographic outcomes after MINST, highlighting the potential generalisability and wide applicability of this approach, further supporting its efficacy for the treatment of intrabony defects.