Intrabony Defect Mesial #12 (Mx left 1st PM) with V-MIS

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Posted on By Jonathan Blansett In Periodontics

Localized 8mm probing depth mesial #12; had progressed from a 5mm pd that was managed with s/rp and perio maintenance up to this point. Site accessed with minimally invasive incision designs, debrided with aid of videomicroscope (Olympus, Uteroreno videoscope). Large groove in center of mesial concavity revealed with line of calculus and advanced bone destruction. Buccal wall still intact(although paper thin), makes detection of these types of defects with only Radiographs very difficult if not impossible, must combine with clinical periodontal exam. Groove plastied with hshp and fine small football diamond bur. Grafted with fdba and emdogain; single 4.0 cg suture to close.

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2 Comments

Bravo. Ultra conservative perio therapies...well done. What is your criteria for using this method over conventional therapies?
Dr. S


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Hey Dr. Salama, thank you! This technique is ideal for localized vertical defects that are often present after initial periodontal therapy. It is also ideal for aesthetically critical areas where you want no/minimal recession. Typically if the probing depth is 6mm or > after initial therapy we will recommend this treatment. The videoscope allows you to see though a smaller incision than you would need otherwise (vs. conventional GTR or regen. perio surgery), typically only in between the affected teeth on the side of the flap (labial or palatal) that has the deepest probing depth...this way you preserve the max. amount of blood supply to your defect site and have virtually no post-surgical recession. I have treated full mouth severe perio cases with this technique also, it is a lot of work, but the results are fantastic...much better than what I could achieve with conventional osseous resective surgery or combination osseous / gtr / regenerative approaches. I'm convinced the key is removing all of the calculus/biofilm. The videoscope is just a tool that allows us to visually confirm it's been removed in an extremely minimally invasive manner. Take care! -jb


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