Conventional versus modified technique of the apically repositioned flap: a comparative study

Background: Inadequate zone of attached gingiva is not sufficient to protect the periodontium from injury occurring due to frictional forces encountered during mastication and dissipate the pull on the gingival margin created by the muscles of the adjacent alveolar mucosa. It also facilitates subgingival plaque formation and results in loss of attachment and soft tissue recession and a shallow vestibular fornix that in turn favours food accumulation. Thus, an adequate zone of attached gingiva is essential for maintenance of periodontal health. The Apically Repositioned Flap is a predictable method of increasing the zone of attached gingiva. This Conventional Apically Repositioned Flap method has been modified by Carnio in 1996, where the existing keratinized tissue is retained as a marginal collar, referred to as Modified Apically Repositioned Flap. Objective: The present study was conducted to compare the results of Conventional Apically Repositioned Flap and Modified Apically Repositioned Flap in terms of changes in width of attached gingiva, apparent gingival recession, sulcus depth and clinical attachment level. Methods: The study comprised of 28 sites in 14 subjects, in a split mouth design. The sites were referred to as Experimental Site ‘A’ and ‘B’, referring to as the Conventional Apically Repositioned Flap and Modified Apically Repositioned Flap, respectively. The clinical parameters were recorded preoperatively on day 0 and again postoperatively on day 90 and 150.The data obtained was analyzed statistically. Results: The results showed that both Conventional and Modified Apically Repositioned Flapsare equally effective and efficient methods for widening the attached gingiva. Conclusion: Both the procedures are equally effective in increasing the zone of attached gingiva, though Modified Apically Repositioned Flaps may be preferred due to its advantages.