Periodontal Rejenerasyonda Minimal İnvaziv Cerrahi Teknikler

Emine Ece Barlay; Gizem Torumtay Cin

doi:10.37609/akya.4124

Yazarlar

Emine Ece Barlay

https://orcid.org/0009-0001-6273-1488

Gizem Torumtay Cin

https://orcid.org/0000-0002-5362-4146

DOI: https://doi.org/10.37609/akya.4124.c6519

Özet

Periodontitis, periodontal dokuların ilerleyici yıkımı ile karakterize kronik inflamatuvar bir hastalık olup sıklıkla kemik içi periodontal defektlerin oluşumuna yol açmaktadır. Bu defektlerin tedavisinde temel amaç, kaybedilen periodontal destek dokularının yeniden oluşturulmasını sağlayarak fonksiyonel ve morfolojik bütünlüğün yeniden kazandırılmasıdır. Son yıllarda periodontal rejeneratif cerrahide doku travmasını azaltmayı ve yara iyileşmesini optimize etmeyi hedefleyen minimal invaziv cerrahi teknikler önem kazanmıştır. Bu yaklaşımlar, sınırlı flep elevasyonu, interdental papil bütünlüğünün korunması ve stabil pıhtı oluşumunun desteklenmesi gibi biyolojik prensiplere dayanmaktadır. Minimal invaziv cerrahi teknikler arasında minimal invaziv cerrahi teknik (MİCT), modifiye minimal invaziv cerrahi teknik (M-MİCT), papil koruyucu teknikler, tek flep yaklaşımı, modifiye vestibüler insizyon subperiosteal tünel erişimi (M-VİSTA), apikal kesikli koronal ilerletme cerrahi tekniği ve periodontal endoskopi destekli kesiksiz rejenerasyon tekniği gibi farklı yöntemler yer almaktadır. Bu teknikler, cerrahi travmayı azaltarak yumuşak doku vaskülaritesini korumayı, primer yara kapanmasını desteklemeyi ve postoperatif dişeti çekilmesini minimize etmeyi amaçlamaktadır. Mevcut klinik bulgular, minimal invaziv yaklaşımların periodontal rejenerasyon tedavilerinde umut verici klinik sonuçlar sunduğunu göstermektedir. Bununla birlikte, teknik hassasiyet gereksinimi ve sınırlı cerrahi erişim gibi faktörler göz önünde bulundurularak uygun vaka seçimi yapılması büyük önem taşımaktadır.

Periodontitis is a chronic inflammatory disease characterised by the progressive destruction of periodontal tissues, which frequently leads to the formation of intraosseous periodontal defects. The primary aim in the treatment of these defects is to restore functional and morphological integrity by regenerating the lost periodontal supporting tissues. In recent years, minimally invasive surgical techniques aimed at reducing tissue trauma and optimising wound healing have gained prominence in periodontal regenerative surgery. These approaches are based on biological principles such as limited flap elevation, preservation of interdental papillae integrity, and promotion of stable clot formation. Minimally invasive surgical techniques include the modified minimally invasive surgical technique (M-MICT), papilla-preserving techniques, the single-flap approach, the modified vestibular incision subperiosteal tunnel access (M-VIST), the apical segmented coronal advancement surgical technique, and the periodontal endoscopy-assisted continuous regeneration technique. These techniques aim to reduce surgical trauma, preserve soft tissue vascularity, support primary wound closure, and minimise postoperative gingival recession. Current clinical findings indicate that minimally invasive approaches offer promising clinical outcomes in periodontal regeneration treatments. However, given factors such as the need for technical precision and limited surgical access, appropriate case selection is of great importance.

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