Papilla-Preserving Gingival Fiber Retention Osseous Surgery in the Anterior Maxilla: A Novel Clinical Technique.
Abdusalam E Alrmali, Hom-Lay Wang
✦ AI-curated · Sources linked
Case in brief
A report described papilla-preserving gingival fiber retention osseous surgery (PP-FibReOS) in two challenging anterior maxillary scenarios: functional crown lengthening and pocket elimination in a patient with stage IV, grade C periodontitis. The technique combined selective coronal tissue removal and conservative bone recontouring with preservation of an interproximal supracrestal fiber complex attached to the palatal flap. At 36 months, both cases had probing pocket depths of 1–3 mm, no bleeding on probing, stable papilla positions, PES scores of 11–12, and patient satisfaction ratings of 10/10.
What made this case unusual
The protocol preserves a de-epithelialized interproximal supracrestal fiber complex on the palatal flap, then closes the papillary complex in two layers, aiming to retain papillary volume during resective surgery.
Diagnostic / clinical pearl
In selected anterior maxillary cases, the report suggests that preserving the interproximal fiber complex while reshaping bone conservatively may balance pocket elimination or crown lengthening with papillary stability.
Why it matters
The two-case proof of concept highlights a potential option when anterior resective surgery must address periodontal or restorative needs while preserving esthetic soft-tissue contours; larger controlled studies are needed to establish indications and predictability.