الفهرس 
Clinical and radiographic evaluation of non-incised papilla surgical approach (nipsa) versus modified minimally invasive surgical technique (m-mist) in treatment of intraosseous defects in :patients with stage iii periodontit A randomized clinical trial
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Abstract
Aim: The aim of the present study was to evaluate the clinical and radiographic effectiveness of Non-
Incised Papilla Surgical Approach (NIPSA) compared to Modified Minimally invasive surgical
technique (M-MIST) in the treatment of periodontal intraosseous defects in stage III periodontitis
patients as: primary outcome: Clinical assessment for clinical attachment level (CAL) following
surgeries for both groups and secondary outcome: Clinical assessment related to reduction in probing
pocket depth (PPD), amount of gingival recession (GR) and radiographic bone fil.
Methodology A total of thirty- two intra-osseous defects in 15 patients suffering from Stage III
Periodontitis, participated in this randomized clinical trial (RCT) without any drop- out. The patients
were divided into two groups with 16 intra-bony defects each. (N=16 patients per each group): group I
(Test group) was received Non-Incised Papilla Surgical Approach (NIPSA), while, group II (Control
group) was received Modified Minimally Invasive Surgical Technique (M-MIST). All the clinical
parameters assessed at baseline and 1 year follow up period. In addition, radiographic parameters
assessed during the same follow up period using standardized digital periapical individualized Extension
Cone Paralleling (XCP) index for each patient. All data was collected, checked, revised, tabulated and
entered into the computer. Statistical analysis was performed and data were explored for normality using
Kolmogorov-Smirnov and Shapiro-Wilk tests. For non-parametric data: Mann Whitney test was used to
compare between two groups in non-related samples. Friedman test was used to compare between more
than two groups in related samples. Wilcoxon test was used to compare between two groups in related
samples. For parametric data: Independent sample t-test was used to compare between two groups in
non-related samples. Repeated measure ANOVA was used to compare between more than two groups in
related samples. Paired sample t-test was used to compare between two groups in related samples.
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Spearman correlation was used to find the correlation between different parameters.
Results: Statistically significant difference in PD, CAL, RH, Gingival bleeding score, radiographic
defect fill and post-surgical patient satisfaction were noted for each groups at different time periods.
However, all clinical and radio graphical parameters revealed intergroup non statistically significant
differences for both groups.
Conclusions: Within the limitations of the present study, we can conclude that minimal invasive surgical
techniques considered the best treatment modalities in improving clinical and radio graphical parameters
and also patient centered outcome