Mangal Shilpi, Kaushal Shalini, Lal Nand
Periodontology, King George's Medical University, Lucknow, IND.
Cureus. 2025 Aug 9;17(8):e89707. doi: 10.7759/cureus.89707. eCollection 2025 Aug.
Minimally invasive surgery (MIS) in periodontology represents a paradigm shift from traditional, trauma-prone surgical procedures to techniques that emphasize tissue preservation, aesthetics, faster recovery, and overall improved patient outcomes. This narrative review delves into the evolution, methodologies, applications, advantages, limitations, and prospects of MIS in periodontal and implant therapy, highlighting key innovations that have refined surgical protocols while enhancing biological and clinical outcomes. The key findings of this narrative review highlight that MIS has significantly advanced periodontal and implant therapy by shifting the focus from extensive tissue resection to preservation, precision, and regeneration. MIS techniques, such as the minimally invasive surgical technique (MIST), modified MIST, vestibular incision subperiosteal tunnel access (VISTA), and tunneling approaches, have demonstrated clear benefits in reducing surgical trauma, enhancing wound stability, and preserving soft tissue architecture, particularly the interdental papillae. These techniques promote faster healing, minimize postoperative complications such as gingival recession, pain, and sensitivity, and offer improved aesthetic outcomes. Furthermore, innovations such as lasers, flapless implant placements, guided sinus augmentation, and soft tissue grafting using allografts have expanded the scope and effectiveness of MIS. Despite some limitations, such as the need for specialized equipment and operator expertise, MIS offers enhanced patient comfort, reduced morbidity, and excellent regenerative outcomes. The integration of robotic-assisted surgery and 3D-guided navigation indicates a promising future for MIS, aligning surgical precision with patient-centered care and long-term clinical success. The evolution of periodontal surgery toward minimally invasive approaches reflects a transformative shift in clinical thinking from aggressive resection to delicate preservation and regeneration. This review comprehensively underscores that MIS is not merely a surgical philosophy but a revolution in periodontal and implant therapy, aligning the goals of biological preservation, aesthetic perfection, and procedural efficiency. As microsurgical and robotic techniques continue to evolve, the scope and success of MIS will expand, making it the cornerstone of contemporary and future periodontal practices.
牙周病学中的微创手术（MIS）代表了一种范式转变，即从传统的、易造成创伤的外科手术转向强调组织保存、美学效果、更快恢复以及整体改善患者预后的技术。本叙述性综述深入探讨了MIS在牙周治疗和种植治疗中的发展历程、方法、应用、优势、局限性及前景，强调了在改进手术方案的同时提高生物学和临床效果的关键创新。本叙述性综述的主要发现表明，MIS通过将重点从广泛的组织切除转向保存、精准度和再生，显著推动了牙周治疗和种植治疗的发展。MIS技术，如微创外科技术（MIST）、改良MIST、前庭切口骨膜下隧道入路（VISTA）和隧道技术方法，已在减少手术创伤、增强伤口稳定性和保留软组织结构（尤其是龈乳头）方面展现出明显优势。这些技术促进了更快的愈合，将诸如牙龈退缩、疼痛和敏感等术后并发症降至最低，并提供了更好的美学效果。此外，激光、无瓣种植体植入、引导性上颌窦提升以及使用同种异体移植物进行软组织移植等创新技术扩大了MIS的范围和有效性。尽管存在一些局限性，如需要专业设备和操作人员的专业知识，但MIS能提高患者舒适度、降低发病率并取得出色的再生效果。机器人辅助手术和3D引导导航的整合预示着MIS的前景广阔，将手术精准度与以患者为中心的护理以及长期临床成功相结合。牙周手术向微创方法的发展反映了临床思维从激进切除到精细保存和再生的变革性转变。本综述全面强调，MIS不仅是一种手术理念，更是牙周治疗和种植治疗的一场革命，使生物学保存、美学完美和手术效率的目标保持一致。随着显微外科和机器人技术不断发展，MIS的范围和成功率将会扩大，使其成为当代及未来牙周治疗实践的基石。
