Clinical and Radiograhic Evaluation of NIPSA With and Without Allograft Plus Platelet Rich Fibrin in the Treatment of Intraosseous Defects in Stage III Periodontitis Patients

Several minimal invasive techniques have been proposed since the last decade aiming to enhance and provide adequate environment for periodontal regeneration. Harrel and Rees proposed minimally invasive surgery (MIS) in 1995 and minimal invasive surgical technique (MIST) that was introduced in 2007 and then further enforced with modified minimally invasive surgical technique (M-MIST) in 2009 . A new minimal invasive technique called Non-Incised Papilla Surgical Approach (NIPSA) was introduced in 2017. It is aims to maintain the marginal tissues integrity by placing horizontal or oblique incision apical to the defect approaching the defect through apical access.

Inclusion Criteria: * Patients with Stage III periodontitis patient having at least one tooth with two wall or combined two to three walled intraosseous defect more than or equal 3 mm deep (assessed by trans-gingival probing, radiographic examination) with clinical attachment level (CAL) more than or equal 5mm and pocket depth (PD) more than or equal 6 mm. * Defect not extending to a root furcation area. * Vital teeth * No history of intake of antibiotics or other medications affecting the periodontium in the previous 6 months. * No surgical periodontal therapy carried out in the past 6 months. * Able to sign an informed consent form. * Patients who are cooperative, motivated, and hygiene conscious. * Able to come for the follow up appointment's needed. Exclusion Criteria: * Any systemic disease that contra-indicates periodontal surgery or may affect healing. * Smokers * Pregnant females * Drug abusers