Soft Tissue Healing and IL-6 Cytokine Levels in Microsurgical and Conventional Open Flap Debridement in Patients with Chronic Periodontitis - A Randomized Clinico-Biochemical Trial

BACKGROUND The present study was conducted to compare clinical outcomes and gingival crevicular fluid (GCF) interleukin (IL)-6 cytokine levels in microsurgical and conventional open flap debridement procedure. METHODS Thirty sites in chronic periodontitis patients were randomly assigned into Group I (microsurgical) and Group II (conventional) open flap debridement in a split-mouth design. Gingival bleeding index (GBI), probing pocket depth (PPD), relative attachment level (RAL) were recorded at baseline and 3 months. GCF IL-6 cytokine levels were assessed at baseline and on 3rd day postoperatively. Pain perception using visual analog score (VAS) and soft tissue healing using early healing index (EHI) were assessed after on 7th day post-surgery. RESULTS There was a significant reduction in gingival bleeding index, probing pocket depth, relative attachment level within both the groups. Intergroup gingival bleeding index scores were statistically significant at the end of 3 months. The difference in visual analog scores between the two groups was found to be statistically insignificant whereas early healing index scores between the groups was found to be statistically significant. Group I showed lower levels of IL-6 on 3rd day postoperatively. It was also found that there was positive correlation of IL-6 levels with clinical parameters such as PPD and RAL. CONCLUSIONS Open flap debridement using microsurgical approach can substantially improve clinical parameters and wound healing compared with conventional macrosurgical approach. IL-6 levels were lower in microsurgical group indicating less invasive surgical approach. KEY WORDS Open Flap Debridement, Periodontal Microsurgery, Wound Healing, IL-6, Cytokine, GCF.