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J Clin Periodontol. 2011 Feb;38(2):157-62. doi: 10.1111/j.1600-051X.2010.01658.x. Epub 2010 Nov 30.

Bone loss after full-thickness and partial-thickness flap elevation.

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Department of Periodontology, Julius-Maximilians-University, Würzburg, Germany.



the aim of this study was to histologically assess whether elevation of partial-thickness flaps results in reduced bone alterations, as compared with full-thickness flap preparations.


in five beagle dogs, both mandibular second premolars (split-mouth design) were subjected to one of the following treatments: Tx1: elevation of a partial-thickness flap over the mesial root of P(2) and performing a notch at the height of the bone. Tx2: elevation of a full-thickness flap over the mesial root of P(2) and performing a notch at the height of the bone. After 4 months, sections were evaluated for: (i) vertical bone loss and (ii) osteoclastic activity using histometry.


elevation of both full- and partial-thickness flaps results in bone loss and elevated osteoclastic activity. Partial-thickness flaps can result in less bone loss than full-thickness flaps, but are subject to some variability.


use of partial-thickness flaps does not prevent from all bone loss. The procedure may result most of the times in less bone loss than the elevation of full-thickness flaps. Further research has to evaluate the determinants of effective outcomes of partial-thickness flap procedures.

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