International Journal of Dentistry Research 2026; 11(2): 30-33 DOI:10.31254/dentistry.2026.11203

Case Report

Management of a Periodontal Intrabony Defect Using the NonIncised Papilla Surgical Approach (NIPSA) Combined with Sticky Bone: A Case Report

Sahana Purushotham¹ , Saurav Shankar Das²

Sahana Purushotham,Saurav Shankar Das

1. Reader, Department of Periodontics, A.J. Institute of Dental Sciences, Mangalore-575004, Karnataka, India
2. Private Practitioner, Guwahati- 781001, Assam, India

*Author to whom correspondence should be addressed.

Received: 25th May, 2026 / Revised: 1st January, 1970 / Accepted: 15th July, 2026 / Published : 27th July, 2026

Abstract

The treatment of periodontal intrabony defects remains a major challenge in regenerative periodontal therapy. Preservation of soft tissue architecture and wound stability are critical factors influencing regenerative outcomes. The Non-Incised Papilla Surgical Approach (NIPSA) is a minimally invasive surgical technique designed to preserve the interdental papilla and marginal tissues while facilitating access to deep periodontal defects. Sticky bone, a combination of particulate bone graft and autologous fibrin, has emerged as a promising regenerative biomaterial due to its enhanced stability and biological properties. A 55-year-old female patient presented with food impaction in the maxillary left canine region. Clinical examination revealed generalized supra- and subgingival calculus with a periodontal pocket associated with tooth 23. Radiographic assessment demonstrated an intrabony periodontal defect. Following Phase I periodontal therapy, regenerative surgery was performed using the Non-Incised Papilla Surgical Approach. Thorough defect debridement was carried out, followed by placement of sticky bone prepared from particulate graft material incorporated within autologous fibrin. The surgical site was stabilized and monitored postoperatively. Clinical evaluation demonstrated satisfactory healing with preservation of interdental papillary architecture and reduction in probing depth. Radiographic examination at three months revealed evidence of bone fill within the defect. No postoperative complications or significant gingival recession were observed. In conclusion, NIPSA combined with sticky bone may represent a predictable and minimally invasive regenerative approach for the management of periodontal intrabony defects, particularly in esthetic areas where preservation of soft tissue contours is essential.