Papilla Reconstruction via Incision and Submucosal Mobilization (PRISM): A Technique Illustration

The loss of interdental papillae in the anterior maxilla presents significant esthetic and functional challenges. This report introduces a refined, tunnel-like surgical technique using a vestibular access incision for three-dimensional papilla augmentation ('Papilla Reconstruction via Incision and Submucosal Mobilization' [PRISM]). Three patients (seven sites) with deficient papillae underwent treatment involving connective tissue grafts (CTGs) from the lateral palate and maxillary tuberosity. The technique aimed to enhance surgical access, preserve vascular integrity, and facilitate atraumatic graft placement. Outcomes were assessed through clinical indices (Papilla Presence Index), volumetric analysis via STL superimposition, and patient-reported esthetic and comfort scores. After 6 months, all sites demonstrated successful healing, significant volumetric gain (vertical: 0.8-1.7 mm; horizontal: 0.8-1.4 mm), and improved patient satisfaction. The proposed approach represents a promising option for papilla reconstruction, combining the advantages of a tunnel technique with a dual-graft harvesting strategy. The loss of interdental papillae in the anterior maxilla presents significant esthetic and functional challenges. This report introduces a refined, tunnel-like surgical technique using a vestibular access incision for three-dimensional papilla augmentation ('Papilla Reconstruction via Incision and Submucosal Mobilization' [PRISM]). Three patients (seven sites) with deficient papillae underwent treatment involving connective tissue grafts (CTGs) from the lateral palate and maxillary tuberosity. The technique aimed to enhance surgical access, preserve vascular integrity, and facilitate atraumatic graft placement. Outcomes were assessed through clinical indices (Papilla Presence Index), volumetric analysis via STL superimposition, and patient-reported esthetic and comfort scores. After 6 months, all sites demonstrated successful healing, significant volumetric gain (vertical: 0.8-1.7 mm; horizontal: 0.8-1.4 mm), and improved patient satisfaction. The proposed approach represents a promising option for papilla reconstruction, combining the advantages of a tunnel technique with a dual-graft harvesting strategy.