Minimally Invasive Vertical Incision Subperiosteal Tunnelling Technique for Targeted Endodontic Surgery: Technical Overview and a Case Report.

AIM: This technical review and case report describes the Minimally Invasive Vertical Incision Subperiosteal Technique (MIVIST) for use in specific targeted endodontic surgical cases.

SUMMARY: The proposed MIVIST technique includes a vertical incision along with auxiliary vertical release incisions to enhance soft tissue healing during targeted endodontic surgery for teeth with small periapical lesions. The technique is described in a case report where a patient presented with persistent periapical periodontitis associated with a previously root canal treated tooth (#15). Based on the preoperative intraoral scan and cone beam computed tomography (CBCT) three-dimensional surgical guides were printed. A vertical main incision and additional release incisions were placed in the buccal mucosa of tooth 15 over healthy bone, with subperiosteal tunnelling then being performed to provide adequate access to the lesion and root apex. A guided osteotomy was carried out using the surgical template, followed by root-end cavity preparation and filling. The patient was followed up over 24 months, when excellent soft tissue healing as well as radiographic healing was apparent.