ANALYSIS OF EXCISIONAL NEW ATTACHMENT PROCEDURE (ENAP) VERSUS GINGIVAL CURETTAGE FOR PERIODONTAL POCKET REDUCTION IN CHRONIC PERIODONTITIS PATIENTS: A CLINICAL ASSESSMENT STUDY

Abstract

Background: Chronic periodontitis is a prevalent inflammatory disease resulting in progressive destruction of the supporting structures of teeth, leading to periodontal pocket formation and clinical attachment loss. Non-surgical periodontal therapy remains the first line of treatment; however, in sites with persistent deep periodontal pockets, adjunctive surgical or semi-surgical procedures may be required to achieve optimal clinical outcomes. Excisional New Attachment Procedure (ENAP) and gingival curettage are two such therapeutic modalities aimed at eliminating diseased pocket epithelium and inflamed connective tissue to promote periodontal healing. This study aims to comparatively evaluate the effectiveness of ENAP and gingival curettage in reducing periodontal pocket depth and improving clinical attachment levels in patients with chronic periodontitis.

Materials & Methods: A total of 20 systemically healthy patients diagnosed with moderate to severe chronic periodontitis, presenting with probing pocket depth (PPD) ≥5 mm, were selected from the Outpatient Department of Periodontology. Patients were randomly allocated into two groups (n = 10 each). Group I underwent gingival curettage following thorough scaling and root planing, while Group II was treated with Excisional New Attachment Procedure after initial periodontal therapy. Clinical parameters including, Gingival Index (GI), Plaque Index (PI), Modified Sulcus Bleeding Index (mSBI), PPD, and Clinical Attachment Level (CAL) were recorded at baseline and at 3 months post-treatment. The collected data were subjected to appropriate statistical analysis.

Results: Both treatment modalities demonstrated significant improvements in clinical parameters from baseline to 3 months. However, Group II (ENAP) showed a greater reduction in PPD and a more pronounced gain in CAL compared to Group I (gingival curettage). The differences between the two groups were found to be statistically significant, suggesting superior clinical efficacy of ENAP in managing deeper periodontal pockets.

Conclusion: Within the limitations of the study, ENAP proved to be more effective than gingival curettage in achieving periodontal pocket reduction and clinical attachment gain in patients with chronic periodontitis. ENAP may therefore be considered a valuable therapeutic option in cases where non-surgical therapy alone is insufficient to control periodontal disease progression.