Minimally invasive surgery has to be considered a true reality in periodontal regenerative surgery. Several clinical trials have shown its efficacy and predictability in the treatment of intrabony defects. The clinical efficacy is consistently associated with a very low morbidity both during surgery and in the post-operative healing period. The minimally invasive surgical procedures require a specific training and the use of dedicated instruments and materials to be successfully applied to the treatment of intrabony defects. Applying microsurgical concepts in the field of periodontal surgery is found to be of great importance.