A Minimally Invasive Surgical Approach for Periodontal Regeneration: Surgical Technique and Observations

Abstract

Increasingly, patients referred to periodontists have undergone some form of non-surgical periodontal treatment prior to their referral. As a result of this, there is an increased need to treat isolated, rather than generalized, periodontal defects. A surgical technique that utilizes small incisions and a limited access approach for treating isolated periodontal defects is described. Results from the use of the minimally invasive surgical (MIS) technique for periodontal regeneration in a comparison study appear to be similar to those where a more traditional surgical approach has been used. Some of the apparent advantages and disadvantages of using the MIS approach are discussed.

Clinical and Systemic Effects of Periodontally Accelerated Osteogenic Orthodontics: A Pilot Study

“…The second is to minimize the postoperative soft tissue recession on the interproximal and buccal aspects of the treated tooth, with the result of compromising the preexisting esthetic impairments, loss of interdental papilla may result in phonetic problems and food impaction (Trombelli et al, 2009). Recently new flap designs for reconstructive procedures have also been proposed to minimize the surgical trauma, leading to a decrease in post-surgical complications and patient discomfort (Trombelli et al;Harrel, 1990;Cortellini & Tonetti, 2007). They are based on a minimally invasive approach with a flap elevation only on one side (buccal or lingual) leaving the soft tissues on the opposite side intact, facilitating flap repositioning and suturing with the undetached oral papilla thus optimizing wound closure for primary intention.…”

Tissue Resistance to Soft Tissue Emphysema during Minimally Invasive Periodontal Surgery

“…Since, during minimally invasive periodontal surgery the incisions are limited to interproximal gingival tissues (free and attached gingiva, periodontal ligament and alveolar bone) and incisions are not extended into adjacent mucosal tissue, 14,15 it was decided that initial testing for tissue resistance to pressure was best performed in pig palatal tissue. The resistance of palatal tissue to penetration of the ink was tested by inserting a 23 gauge butterfly needle into the palatal tissue.…”

“…The design of minimally invasive surgical incisions has been previously described in the literature. 14,15 The minimally invasive surgical site was filled with 0.2 ml of India ink solution. A videoscope with the antifouling device attached was then inserted into the surgical site (Fig.…”

Minimally invasive periodontal therapy

“…[40] MIPS may also suit a periodontal defect that borders on an edentulous area. A less ideal site for MIPS, but one where the technique can be used, is a defect that extends to the buccal and/or lingual from the interproximal area.…”