Fibre retention osseous resective surgery: a novel conservative approach for pocket elimination

Abstract

The position of the most apical inter-dental portion of the alveolar crest is classically used in osseous resective surgery (ORS) to establish the amount of the inter-proximal and buccal/lingual bone resection. Supracrestal fibres connected to the root cementum are always present coronal to the alveolar crest both in healthy and diseased sites. The aim of this paper is to report a novel surgical approach that combines the classical method of osseous resection with the gingival fibre retention technique. A description of the surgical procedure in four steps is provided (flap design, marginal soft tissue removal and fibre retention, ORS, suture of the flap). The proposed technique shifts the bottom of the defect in a more coronal position at the level of the connective tissue fibre attachment, establishing a more conservative supporting bone resection.