Successful periodontal regenerative therapy in molar regions requires adequate surgical access and preservation of the interdental papilla. Although various minimally invasive techniques are available, accessing deep bone defects in molar regions while maintaining blood supply to the papilla remains challenging. In this context, interdental papilla incision designs that shift the incision line to the buccal or palatal aspect-such as the papilla preservation technique, modified papilla preservation technique, and triangle papilla access approach-are considered to contribute to improved visibility in periodontal regenerative therapy in the molar region using the operating microscope (OM). Building on this, the present case study proposes a new decision-making framework for interdental papilla incision design, with an emphasis on enhancing visibility under the OM and considering the anatomical relationship between flap design and blood supply.
Shibazaki et al. (Sun,) studied this question.