Videoscope-Assisted Minimally Invasive Surgery (VMIS) for Bone Regeneration around Teeth and Implants: A Literature Review and Technique Update.

Stephen Harrel

doi:10.3390/dj6030030

Abstract

Background—The literature related to minimally invasive periodontal surgery is reviewed. This includes the original minimally invasive surgery (MIS) procedure for bone regeneration, the modification of MIS for the minimally invasive surgery technique (MIST) and modified MIST (M-MIST) procedures, and the introduction of the videoscope for oral surgical procedures and the ability to perform videoscope-assisted minimally invasive surgery (VMIS). The evolution from MIS through MIST to the current VMIS is reviewed. The results from studies of each of these methods are reported. Conclusion—The use of small incisions that produce minimal trauma and preserve most of the blood supply to the periodontal and peri-implant tissues results in improved regenerative outcomes, minimal to absent negative esthetic outcomes, and little or no patient discomfort. Minimally invasive procedures are a reliable method to regenerate periodontal tissues.

Highlights

The literature related to minimally invasive periodontal surgery is reviewed.This includes the original minimally invasive surgery (MIS) procedure for bone regeneration, the modification of MIS for the minimally invasive surgery technique (MIST) and modified MIST (M-MIST) procedures, and the introduction of the videoscope for oral surgical procedures and the ability to perform videoscope-assisted minimally invasive surgery (VMIS)
MIS and MIST used very similar incisions and tissue handling to achieve improvements in pocket probing depths and clinical attachment with minimal soft tissue changes. Both procedures yielded results that were equal to or improved over the regenerative results gained with traditional regenerative procedures such as bone grafts or guided tissue regeneration. Despite these excellent and consistent results from two separate research centers, minimally invasive small incision surgery did not become a routine approach for regeneration of bone in periodontal defects
Because the lens becomes obscured very quickly in the small surgical access used for MIS or MIST, it is impossible to use an optical device like a videoscope or endoscope without a method that keeps the lens clean

Summary

Literature Review

Periodontal minimally invasive surgery for bone regeneration, termed MIS, was first described by Harrel and Rees in 1995 [1]. MIS and MIST used very similar incisions and tissue handling to achieve improvements in pocket probing depths and clinical attachment with minimal soft tissue changes. Both procedures yielded results that were equal to or improved over the regenerative results gained with traditional regenerative procedures such as bone grafts or guided tissue regeneration. Despite these excellent and consistent results from two separate research centers, minimally invasive small incision surgery did not become a routine approach for regeneration of bone in periodontal defects. It can be extremely difficult to visualize the base of a defect or the accretions on a root surface with the technology used in the previously discussed studies, i.e., surgical loops or surgical microscope

Visualization Techniques

The incisions for Videoscope-Assisted

Summary

11. Videoscope