Minimally Traumatic Surgical Procedures in Periodontics: a Review

Resumo

The concept of minimally invasive procedures can be extended to all fields of dentistry. Periodontics, in particular, has been reported as one of the areas with great benefits. This review aims to describe the use of minimally invasive procedures in periodontal surgery, its concepts, applications, and possible benefits from its use. For that, 682 articles published between 1950 and 2012 focused on minimally invasive periodontal surgery were evaluated. Of them, 669 studies did not describe clearly the procedures, and did not attend the inclusion criteria. The results showed that proper lighting promotes increased visual acuity during surgical procedures, favoring the precision associated with microsurgical instruments specifically designed, allowing a more accurate manipulation of the soft and hard tissues. Surgical access avoids unnecessary tissues removal, optimizing the debridement, improving vascularisation, and therefore the possibility of obtaining primary healing of surgical wounds. The microsurgical approach can improve the predictability of different periodontal procedures, providing better results and cause less postoperative discomfort. However, few controlled methodologies on the use of instruments to promote minimally invasive procedures in periodontics have been found in literature. Therefore, studies are needed to determine whether microsurgical techniques can lead to a significant difference in the successful outcome. Most of the studies are based on observations and experiences of the authors, which clearly show that there are advantages in having better lighting, better vision, and a more controlled and less traumatic technique.