Granulation Tissue From Residual Periodontal Pockets

Histological Analysis of Granulation Tissue From Residual Periodontal Pockets

This observational study aims to describe the histopathological features of granulation tissue (GT) found in residual periodontal pockets at the time of surgical intervention, after completion of the first two steps of periodontal therapy, according to EFP guidelines (Sanz et al., 2020).

A secondary objective was to analyze GT characteristics in relation to clinical outcomes (e.g., defect type, probing depth reduction and clinical attachment gain) in order to identify possible statistical associations between tissue patterns and clinical improvements.

The study was conducted at the Section of Periodontology, Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Italy.

Ethical approval was obtained from the Sapienza University Ethics Committee (6997 / 23-01-2023).

Granulation tissue samples were collected during standard periodontal surgery from tissues that would normally be removed, without any additional intervention for the enrolled patients.

Inclusion Criteria:

• Age 18-75 years
• Full Mouth Plaque Score (FMPS) <15% at re-evaluation
• Full Mouth Bleeding Score (FMBS) <15% at re-evaluation
• At least one site with probing depth (PPD) ≥5 mm after non-surgical therapy
• Written informed consent
• Good compliance throughout periodontal therapy

Exclusion Criteria:

• Pregnancy or breastfeeding
• Use of systemic or local antibiotics in the previous 3 months
• Smoking
• Use of anti-inflammatory or anticoagulant/antiplatelet drugs
• Systemic, cardiovascular, or infectious diseases affecting periodontal health
• Dental contraindications to surgery (fractures, untreated endodontic lesions, mobility > grade 2, or faulty restorations)
• Non-compliant patients
• History of periodontal therapy in the previous year
• Ongoing orthodontic treatment