A novel biopsy technique for lesions involvinginterproximal soft tissues

Background: Biopsy of soft tissues around teeth can cause periodontal deficiency with several side effects. When the neoformation involves frontal areas biopsy often induces an aesthetic impairment, particularly critical when the interdental papilla is entailed. Description of the procedure: A new surgical approach to treat lesions involving interdental tissues is described. The flap design is characterized by a sub-marginal scalloped incision, possibly confined into the keratinized tissue at the vestibular side. The incision starts 1 mm above the lesion, in the midline between the two confining teeth. With a parabolic shape, the incision reaches the gingival margin at the distal line angle of the distal tooth. Hence, another parabolic incision is performed connecting the starting point with the marginal mesial line angle of the mesial tooth. After this step, two options are applied depending on the lesion extension. When the lesion is confined coronally to the line connecting the gingival margin zeniths of the two adjacent teeth, oblique linear incisions are performed till to the gingival margin zeniths. Otherwise, when the lesion extends beyond this line, two parabolic incisions are per-formed on both adjacent teeth, till to the distal and mesial line angle respectively. Specific anatomic measurements rule up the incisional design. For the palatal/lingual side, the incision follows the principles of a general excisional procedure. Intrasulcular incisions are then made and the lesion with surrounding tissues are collected for examination. Both full-thickness and split-thickness are used for the buccal flap elevation. De-epithelized the adjacent anatomic papillae, two sling sutures are used to stabilize the entire flap to the most feasible coronal position. Generally single sutures are used for the palatal side and the eventual graft. Outcomes: All 9 cases treated so far have ever shown an esthetically satisfying outcome without recurrence or adverse events. Conclusions: This technique allows clinician to restore gingival health preserving aesthetics and function.