Cosmetic dentistry beauty & science

technique _ periodontal regenerative therapy I achievedintheinfrabonydefectwithlittleincrease of gingival recession. More recently, minimally invasive approaches have been suggested. The Single Flap Approach (SFA) is the elevation of a single flap (either buccal or lingual), keeping intact the tissues on the other flap. The Minimally Invasive Surgical Technique (MIST) is an adaptation of the papilla preservation techniques with the intent to limit flap elevation and mesiodistal extension of the flap. With these approaches,theoutcomesintermsofRECworsen- ingweremoreencouragingandreducedthelossof soft tissue to almost nothing. Finally, Coronally Advanced Flaps (CAF) in com- bination with regenerative approaches have been introduced with the intent of stabilising the soft tissue and providing a more stable wound for re- generationtooccur.Withthisapproach,adecrease in REC can be achieved, thus not only addressing the loss of attachment but also improving the aes- thetic appearance of the area. The Soft Tissue Wall technique is recommended for the treatment of infrabony defects in the aes- thetic area, when one of the involved teeth has also experienced an apical migration of the free gingival margin. _Soft Tissue Wall technique Inthisapproach,ahorizontalincisionismadeat thebaseoftheinterdentalpapillaeandextendedto one tooth mesially and distally from the infrabony defect. A full-thickness trapezoidal flap (with the widerbaseapicallypositioned)isthenelevated.The remaining facial portion of the anatomic papillae ispreservedandde-epithelialisedinordertocreate connective tissue beds to which the flap can be securedatthetimeofsuturing.Thepapillaoverthe infrabony defect is dissected at its base and the entire interproximal supracrestal soft tissue is ele- vated in order to gain proper access to the defect. After flap elevation, the granulation tissue is re- movedfromthedefectsbymeansofmetalcurettes, followed by scaling and root planning using metal curettes and power-driven instrumentation. Sharp and blunt dissection into the vestibular lining mucosa is performed to eliminate muscle tension and permit coronal displacement of the flap. Flap mobilisation is considered adequate AD