Periodontal Regenerative Treatment of Intrabony Defects in the Esthetic Zone Using Modified Vestibular Incision Subperiosteal Tunnel Access (M-VISTA)

Periodontal regenerative treatment of intrabony defects in the esthetic zone often poses a significant challenge to clinicians. Various materials and techniques have been proposed to achieve periodontal regeneration. This article presents modified vestibular incision subperiosteal tunnel access (M-VISTA) for treatment of intrabony defects in the esthetic zone. Two cases were treated using the proposed approach with enamel matrix derivatives and demineralized freeze-dried bone allograft to optimize the regenerative outcomes without affecting the soft tissue profile in the esthetic zone. Two different indications were described with addition of acellular dermal matrix and specific suturing techniques based on each particular clinical scenario. Clinical and radiographic follow-up of 18 months revealed successful outcomes of the proposed minimally invasive approach with no postoperative gingival recession. Patient-centered outcomes were highlighted as another major consideration in periodontal regeneration.