The loss of interdental papillae as the result of trauma or inflammatory periodontal disease creates a significant challenge in the esthetic zone. Conventional surgical techniques are unpredictable because of small working spaces and limited blood supply to the area. Vertical releasing incisions can further jeopardize vascular channels and leave unattractive scarring upon healing. The application of microscopes and microsurgical instruments presents a new frontier for predictable esthetic results. This paper describes a predictable microsurgical technique for reconstruction of the interdental papillae. (Int J Periodontics Restorative Dent 2008;28:543–549.)

Beyond every general practitioner who excels in cosmetic and esthetic restorative dentistry, there usually stands a gifted periodontist who shares a similar passion for achieving symmetry and artistry. La Jolla, Calif.-based periodontist Dr. Peter Nordland is among a growing number of doctors within his specialty who have sharpened their focus on achieving optimum esthetics. Here clinical editor Dr. David Hornbrook, who has a close-working referral relationship with Dr. Nordland, explores specific ways GPs and periodontists can deliver better results for patients who are committed to appearance-enhancing treatment.

Periodontal plastic microsurgery incorporates the use of a surgical dissecting microscope in an attempt to increase visibility, minimize trauma, and enhance surgical results. This paper will attempt to demonstrate how periodontal plastic surgery utilizing periodontal microsurgery could contribute in the role of soft tissue modification to enhance the smile and ideally allow for improved oral facial esthetics.