MODIFIED PERIOSTEAL RELEASING INCISION IN IMPLANT DENTISTRY

Modified periosteal releasing incision (MPRI) represents an evolution of the conventional periosteal releasing incision (PRI) used in implant dentistry to advance mucoperiosteal flaps in guided bone regeneration (GBR). MPRI employs a shallow (~0.5 mm) horizontal periosteal incision at the base of a full-thickness flap, combined with controlled lateral stretching, rather than deeper or multiple vertical incisions of PRI. This modification aims to reduce postoperative complications such as swelling, bleeding, paresthesia (particularly in the posterior mandible near the mental nerve), and patient discomfort while still providing sufficient flap mobility for tension-free primary closure. Early case reports demonstrated vertical flap advancement of > 10 mm without nerve injury. More recent clinical studies and ex vivo investigations confirm that MPRI achieves similar flap advancement (~8 mm) as mucosal detachment techniques, while periosteal suturing significantly reduces graft displacement regardless of technique. Updates published in 2025 including visualization of the mental nerve emphasize safety improvements. This article reviews surgical principles, anatomical considerations, indications, flap biomechanics, complications, and clinical outcomes compared to alternative techniques.