SP-22 Advanced Soft Tissue Management in Endodontic Microsurgery: Addressing the Usual Culprits

CE Hours: 1.0

Description: Effective soft tissue management plays a critical role in the success of endodontic microsurgery, especially in achieving esthetic and functional outcomes. This presentation will begin by highlighting the historical evolution of flap designs-from conventional techniques such as the semilunar, intrasulcular, and submarginal flaps to the transition toward papilla-based incisions-illustrated through clinical cases that demonstrate their advantages and limitations. Established periodontal techniques such as the VIP approach, entire papilla preservation, the coronally advanced flap, and the bilaminar technique-now increasingly embraced in endodontic microsurgery-will be presented with a focus on their ability to prevent scar tissue formation and prevent or even improve gingival recession. Particular emphasis should be given on techniques for tissue elevation, manipulation, and reapproximation, as demonstrated through a wide array of clinical examples. The lecture will underscore how soft tissue and periodontal considerations, once overlooked in endodontic surgery, are now vital for achieving predictable, long-term, and esthetically pleasing outcomes.

Learning Objectives:  

• Describe the evolution of soft tissue flap designs in endodontic microsurgery and their clinical implications.
• Evaluate the benefits and limitations of the VIP approach, entire papilla preservation, coronally advanced flap, and the bilaminar technique.
• Apply principles of soft tissue elevation, manipulation, and reapproximation to minimize postoperative complications such as scar formation and gingival recession.