Periodontal Regenerative Treatment of Intrabony Defects in the Esthetic Zone Using Modified Vestibular Incision Subperiosteal Tunnel Access (M-VISTA)

Najafi, Babak; Kheirieh, Parisa; Cappetta, Emil G

doi:10.11607/prd.3138

Cited by 14 publications

(13 citation statements)

References 15 publications

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“…Although techniques using an apical approach have been widely developed and used in mucogingival surgery with good results, [28][29][30] only a few preliminary studies describe the apical approach for periodontal reconstructive surgery. 20,31 Comparison of the two techniques showed no significant differences in PDr, but significant changes in CAG (P < 0.05), with more favorable results for the NIPSA group at 1 year. These results are due to a different response of the soft tissues (REC, TP, KT) according to the approach used.…”

Section: Discussionmentioning

confidence: 94%

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Periodontal reconstructive surgery of deep intraosseous defects using an apical approach. Non‐incised papillae surgical approach (NIPSA): A retrospective cohort study

Rodríguez

Ruiz

Caffesse

2018

Journal of Periodontology

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Background The objective of this study was to compare a minimally‐invasive surgical technique (MIST) and a non‐incised papilla surgical approach (NIPSA) in periodontal reconstructive surgery of deep intraosseous defects. Methods Data on 30 patients with a deep intraosseous defect treated with MIST (n = 15) or NIPSA (n = 15) were analyzed retrospectively. All patients met the same inclusion criteria and were treated following the same protocol, except for the surgical management of soft tissue (MIST versus NIPSA). Clinical parameters at baseline and at 1‐year post‐surgery, early healing at 1 week, and postoperative pain were assessed. Results NIPSA and MIST resulted in significant clinical attachment gain (CAG) (P < 0.001) and probing depth reduction (PDr) (P < 0.001) at 1‐year post‐surgery. However, NIPSA resulted in significantly lower recession of the tip of the interdental papilla compared with MIST (P < 0.001). Smoking negatively influenced early healing in both techniques (P < 0.05). Conclusions NIPSA and MIST both resulted in significant improvements in clinical parameters. NIPSA showed significant soft tissue preservation. NIPSA may represent a promising papillae preservation technique in the treatment of intraosseous periodontal defects.

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Section: Discussionmentioning

confidence: 94%

“…For NIPSA there is only one preliminary study, which showed results similar to the present ones. Although techniques using an apical approach have been widely developed and used in mucogingival surgery with good results, only a few preliminary studies describe the apical approach for periodontal reconstructive surgery …”

Section: Discussionmentioning

confidence: 99%

Periodontal reconstructive surgery of deep intraosseous defects using an apical approach. Non‐incised papillae surgical approach (NIPSA): A retrospective cohort study

Rodríguez

Ruiz

Caffesse

2018

Journal of Periodontology

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“…[3][4][5]62 Therefore, it is not surprising that some authors have proposed the use of periodontal plastic surgery techniques when treating intrabony defects to maintain, or coronally advanced the level of the gingival margin. 3,4,[62][63][64] Zucchelli and De Sanctis proposed a modified approach for the treatment of intrabony defects (with EMD), that involved the use of an envelope coronally advanced flap, 3 as described previously in root coverage procedures. 65 The buccal flap was released, coronally advanced, and anchored to the defect's de-epithelialized adjacent papillae.…”

Section: Ta B L E 1 Strategies For Papilla Augmentation In Healthy Dentitionmentioning

confidence: 99%

“…63,68 Indeed, in a recent randomized controlled trial, the authors showed that the entire papilla preservation technique resulted in a 100% primary wound closure, with a significant CAL gain and a negligible increase in recession depth (0.2-0.36 mm). 69 Other approaches avoiding incisions at the level of the papilla have been described, such as the modified vestibular incision subperiosteal tunnel access (M-VISTA) 64 and the "non-incised papillae surgical approach" (NIPSA). 70 According to Moreno Rodriguez et al, the NIPSA achieved similar outcomes to a traditional minimally invasive papilla preservation technique, with a significantly lower recession at the tip of the interdental papilla (increased recession depth 0.2 versus 0.73 mm 1 year after, respectively).…”

Section: Ta B L E 1 Strategies For Papilla Augmentation In Healthy Dentitionmentioning

confidence: 99%

“…Other approaches avoiding incisions at the level of the papilla have been described, such as the modified vestibular incision subperiosteal tunnel access (M‐VISTA) 64 and the “non‐incised papillae surgical approach” (NIPSA) 70 . According to Moreno Rodriguez et al., the NIPSA achieved similar outcomes to a traditional minimally invasive papilla preservation technique, with a significantly lower recession at the tip of the interdental papilla (increased recession depth 0.2 versus 0.73 mm 1 year after, respectively) 70 .…”

Section: Introductionmentioning

confidence: 99%

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Interproximal attachment gain: The challenge of periodontal regeneration

Rasperini

Tavelli

Barootchi

et al. 2020

Journal of Periodontology

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The new classification of periodontal diseases recognizes the key role of the interdental clinical attachment for defining the periodontal status and the extent of disease severity. Regenerating interdental clinical attachment not only improves the prognosis of the tooth, but it also lessens the severity of the disease condition. This manuscript provides a state-of-the-art review on surgical reconstructive approaches for treating papillary deficiency associated with soft and hard tissue interproximal defects. Combination therapy of papilla preservation, connective tissue grafting, and coronally advanced flaps may result in regeneration of the intrabony defect coupled with root coverage. Future research highlighted here may have the potential, especially in combination approaches, to repair challenging interproximal soft and hard tissue deficiencies.

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Double‐sided entire papilla preservation technique in the combination periodontal regenerative therapy: A case report

Ogawa

Yoshikawa

Ishikawa³

et al. 2023

Clin Adv Periodontics

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BackgroundWith the entire papilla preservation (EPP) technique, it is possible to perform regenerative therapy without incisions in the interdental papilla and to reduce the risk of papillary rupture. However, one limitation of the EPP is the sole access from the buccal side. Here, we present a case of periodontitis treated by the combination regenerative therapy employing the Double‐sided (buccal‐palatal) EPP (DEPP) technique, which adds a palatal vertical incision to the EPP.MethodsA patient with 1–2 wall intrabony defects received the regenerative therapy using recombinant human fibroblast growth factor (rhFGF)‐2 and carbonate apatite (CO3Ap). Using the DEPP technique, vertical incisions at buccal and palatal aspects were placed to gain adequate access to the 1–2 wall intrabony defects between #11 and #12 without incision in the interdental papilla. After debridement, rhFGF‐2 and CO3Ap were applied to the defect. Periodontal clinical parameters and radiographic images were evaluated at the first visit, following initial periodontal therapy (baseline), 6, 9, and 12 months postoperatively.ResultsWound healing was uneventful. Scarring of the incision lines was minimal. At 12 months postoperatively, probing depth reduction was 4 mm, clinical attachment gain was 4 mm, and gingival recession was not observed. An improvement in radiopacity in the previous bone defect was observed.ConclusionThe DEPP is an innovative technique that allows approaching from both the buccal and palatal sides while ensuring flap extensibility without compromising the interdental papilla. This report suggests that the combination of regenerative therapy with the DEPP may be promising in the treatment of intrabony defects.Key pointsWhy is this case new information? The DEPP allows a direct visual approach to a 1–2 wall intrabony defect extending from the buccal to palatal sides, and increases flap extensibility, without compromising the papilla. What are the keys to the successful management of this case? Assessment of three‐dimensional bone defect morphology is required. Computed tomography images are very useful. The flap elevation just under the interdental papilla should be carefully performed with a small excavator to avoid damage to the interdental papilla. What are the primary limitations to success in this case? Despite the addition of a palatal incision, it was not possible to obtain complete flexibility of the palatal gingiva. Caution must be taken in a case in which the distance between the interdental papilla is narrow. Even if the interdental papilla is ruptured during the operation, recovery is possible by continuing the operation and suturing the rupture at the end.

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Periodontal Regenerative Treatment of Intrabony Defects in the Esthetic Zone Using Modified Vestibular Incision Subperiosteal Tunnel Access (M-VISTA)

Cited by 14 publications

References 15 publications

Periodontal reconstructive surgery of deep intraosseous defects using an apical approach. Non‐incised papillae surgical approach (NIPSA): A retrospective cohort study

Periodontal reconstructive surgery of deep intraosseous defects using an apical approach. Non‐incised papillae surgical approach (NIPSA): A retrospective cohort study

Interproximal attachment gain: The challenge of periodontal regeneration

Double‐sided entire papilla preservation technique in the combination periodontal regenerative therapy: A case report

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