Minimally Invasive Surgical Therapy in Periodontology-A Comprehensive Review

Abstract

Minimally invasive surgical therapy (MIST) has introduced a new direction in periodontology, offering reliable outcomes with less surgical trauma. Traditional periodontal surgeries often required extensive flap elevation, which contributed to complications such as gingival recession, root sensitivity, and esthetic concerns. MIST is based on limited incisions, split-thickness flap elevation, advanced visualization with loupes, microscopes, or videoscopes, and precise wound closure that maintains blood supply and accelerates healing. These features improve patient comfort while supporting predictable regenerative success. The approach is applied in regenerative procedures, mucogingival surgeries, and implant interventions. Techniques such as the Whale’s Tail design, Pinhole Surgical Technique, and Vestibular Incision Subperiosteal Tunnel Access have shown promising esthetic and functional outcomes. In implantology, modified trephination and balloon-assisted sinus lift highlight its clinical versatility. Although MIST is technique-sensitive and requires advanced training, future integration of imaging technologies and robotic assistance may enhance precision. Collectively, it represents a patient-centered and regenerative approach in periodontal therapy.