Stephen K. Harrel

A Videoscope for use in Minimally Invasive Periodontal Surgery

INTRODUCTIONnMinimally invasive periodontal procedures have been reported to produce excellent clinical results. Visualization during minimally invasive procedures has traditionally been obtained by the use of surgical telescopes, surgical microscopes, glass fibre endoscopes or a combination of these devices. All of these methods for visualization are less than fully satisfactory due to problems with access, magnification and blurred imaging.nnnCLINICAL INNOVATIONnA videoscope for use with minimally invasive periodontal procedures has been developed to overcome some of the difficulties that exist with current visualization approaches. This videoscope incorporates a gas shielding technology that eliminates the problems of fogging and fouling of the optics of the videoscope that has previously prevented the successful application of endoscopic visualization to periodontal surgery. In addition, as part of the gas shielding technology the videoscope also includes a moveable retractor specifically adapted for minimally invasive surgery.nnnDISCUSSIONnThe clinical use of the videoscope during minimally invasive periodontal surgery is demonstrated and discussed.nnnCONCLUSIONnThe videoscope with gas shielding alleviates many of the difficulties associated with visualization during minimally invasive periodontal surgery.

Frequency of Root Surface Microgrooves Associated with Periodontal Destruction.

Small linear microgrooves have been observed on root surfaces associated with osseous defects when videoscope-assisted minimally invasive surgery (V-MIS) is performed. The aim of this study was to evaluate the frequency of occurrence of these microgrooves associated with osseous defects. Videos of dry skulls from an anatomy department collection and videos made during consecutive V-MIS procedures on patients were evaluated to determine the presence or absence of microgrooves associated with osseous defects. In the dry skulls, 69 areas of apparent periodontal osseous defects were evaluated. In the V-MIS videos, 63 osseous defects were evaluated. In the dry skulls, 34 sites were positive for microgrooves on the root surfaces (49%), while in the V-MIS procedures 50 sites were positive for microgrooves (79%). Microgrooves of unknown origin were detected in a high percentage of osseous defects. Microgrooves may represent risk factors for site-specific progression of periodontal destruction.

Minimally Invasive Periodontal Therapy: Clinical Techniques and Visualization Technology

Minimally Invasive Periodontal Therapy evaluates the advantages of using minimal invasive techniques, the technologies available for enhancing visualization during minimally invasive therapy, and step–by–step illustrates the clinical use of each technique. Each chapter addresses the advantages and disadvantages of minimally invasive therapies, rationale for the approach, and the advantages and limitations of each of the current methods of improving visualization. The chapters then provide an evidence–based review of the technologies and procedures, and end with case studies for each visualization procedure, featuring clinical photographs.