Periodontal microsurgery: Historical development and integration into periodontics

Periodontal microsurgery is a refined enhancement of the various types of periodontal and implant surgery using a binocular surgical microscope, with techniques, instruments and sutures borrowed from medicine. A continuing education program on periodontal microsurgery was first presented to the American Academy of Periodontology Annual Meeting in Orlando in 1992. It has taken over 30 years to gain the attention of the Academy membership due to the additional specialized training, equipment and practice necessary to become and remain proficient in microsurgical techniques. True periodontal microsurgery exceeds surgery using surgical loupes. An operating surgical microscope offers varying magnifications from two and a half to 25 times normal vision. This enhances the surgeon's ability to perform more accurate, smaller initial butt joint incisions, achieve uniform flap thickness, remove all tissue tags, perform the various types of periodontal and implant surgery, and precisely reposition the postsurgical tissues for primary closure. Proficient periodontal microsurgical treatment results in less patient discomfort, faster healing, more predictable treatment results, and better patient acceptance. KEY POINTS: The incorporation of microscopic magnification into periodontal practices, with the necessary and appropriate training and practice, results in improved visual acuity, ergonomic benefits, increased precision in flap design, surgical detailing, and suture closure. The increased precision results in faster and improved healing results and enhanced patient acceptance.