North Texas Dentistry Volume 9 Issue 4 2019 ISSUE 4 DE | Page 6

The treatment of the destruction caused by periodontal dis- ease has benefited greatly from new minimally invasive sur- gery (MIS) techniques. Minimally invasive surgery reduces the tissue trauma and compromised blood supply associ- ated with flap reflection and helps achieve better postoper- ative results. As technology rapidly evolved over the past two decades, surgical loupes, fiberoptic endoscopes, and surgical microscopes each advanced the capabilities of the periodontal surgeon. Although these new tools yielded sig- nificant improvements, they were also hampered by limita- tions in magnification and visualization, and often involved steep learning curves for the clinician. While the introduc- tion of minimally invasive surgical techniques improved results by reducing tissue trauma, visualization has been a troublesome limiting factor. The recent advent of a video- scope for minimally invasive periodontal surgery has dra- matically improved visual access and made it possible to decontaminate affected areas more thoroughly and effec- tively, thereby leading to more predictable regeneration. cover feature Improving Minimally Invasive Periodontal Surgery with a Better View Working at the Leading Edge of Periodontal Regeneration Dr. Daniel M. Stewart by Tina Cauller 6 NORTH TEXAS DENTISTRY | Dr. Daniel M. Stewart performs Video-assisted Minimally Invasive Surgery (VMIS) for periodontal regeneration using the recently released MicroSight ® videoscope (Q-Optics, Duncanville, TX). The MicroSight videoscope consists of a handpiece with a high-definition digital camera at the end of a thin (2.7mm diameter) flexible tube. The device fea- tures a carbon fiber retractor that can be rotated to aid in flap reflection. The MicroSight utilizes patented Air Shield technology to produce a constant stream of air that flows over the videoscope. The gentle airflow moves surgical debris and fluid out of the visual field to provide an unob- structed and clear live-feed image to the high-resolution monitor. The integrated tissue retractor tip allows Dr. Stewart to clearly visualize and treat areas of periodontal and implant bone loss via small, minimally invasive incisions. For Dr. Stewart, the most common use for the MicroSight is for treatment of interproximal pockets and bone loss. A small (approximately 3mm) horizontal incision is made, most often on the lingual surface, and a mini flap is carefully reflected with sharp dissection. This small incision provides sufficient access to the periodontal defect when the MicroSight is used. “I believe that the small incisions and careful atraumatic handling of the tissue, in combination with superior visualization, are the keys to the results we see when using the VMIS technique,” Dr. Stewart reports. The MicroSight videoscope was brought to the market late in 2018 after years of development. Dr. Stewart placed him- self on the waiting list for the MicroSight over two years before its release and is one of the first clinicians to incor-