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Minimally Invasive Vertical Incision Subperiosteal Tunnelling Technique for Targeted Endodontic Surgery: Technical

Francesc Abella Sans1, Jaime Barragán Montes2, Tomasz Zbozen3

  • 1Department of Endodontics, Universitat International de Catalunya, School of Dentistry, Sant Cugat del Valles, Barcelona, Spain.

International Endodontic Journal
|August 8, 2025
PubMed
Summary

The Minimally Invasive Vertical Incision Subperiosteal Technique (MIVIST) offers enhanced soft tissue healing for endodontic surgery. This technique, demonstrated in a case report, shows excellent healing outcomes for periapical lesions.

Keywords:
case reportsurgical guidetargeted endodontic microsurgeryvertical incision

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Area of Science:

  • Endodontics
  • Oral Surgery
  • Dental Technology

Background:

  • Persistent periapical periodontitis requires effective surgical intervention.
  • Traditional surgical approaches may have limitations in soft tissue healing.
  • Minimally invasive techniques are increasingly sought in endodontic surgery.

Purpose of the Study:

  • To describe and evaluate the Minimally Invasive Vertical Incision Subperiosteal Technique (MIVIST).
  • To present a case report demonstrating MIVIST for targeted endodontic surgery.
  • To assess the efficacy of MIVIST regarding soft tissue and radiographic healing.

Main Methods:

  • A novel MIVIST approach involving vertical and auxiliary release incisions.
  • Subperiosteal tunnelling for access to periapical lesions and root apices.
  • Utilisation of 3D surgical guides based on intraoral scans and CBCT.
  • Guided osteotomy, root-end cavity preparation, and filling.

Main Results:

  • Successful application of MIVIST in a patient with persistent periapical periodontitis.
  • Excellent soft tissue healing observed over a 24-month follow-up period.
  • Apparent radiographic evidence of periapical lesion healing.

Conclusions:

  • The MIVIST technique facilitates enhanced soft tissue healing in targeted endodontic surgery.
  • MIVIST is a viable approach for managing teeth with small periapical lesions.
  • The technique demonstrates promising results for both soft tissue and radiographic healing.