Transpositioned Flap Vestibuloplasty Combined with Implant Surgery in the Severely Resorbed Atrophic Edentulous Ridge

Abstract

The use of transpositioned flap (lipswitch) vestibuloplasty combined with implant surgery in patients with severely resorbed atrophic edentulous ridges is reviewed. The cases of 17 patients with severely resorbed atrophic edentulous ridges at the mandible undergoing implant rehabilitation were reviewed. Lipswitch vestibuloplasty was followed immediately by the implant surgery. Postoperative follow-up consisted of clinical and radiographic examinations. Seventeen patients with atrophic ridges (12 class II and 5 class III) each had 2 implant fixtures placed in the mandible as abutments for a clip and bar overdenture. The average time of follow-up was 6 years. Before surgery, all patients had severely atrophic ridges with a compromised shallow vestibule of varying degrees. Satisfactory results were observed in regard to the immediate and long-term morphology of the vestibule, the health of the peri-implant tissue, the stability of implant fixtures, and the functionality of the prostheses. The lipswitch vestibuloplasty offers a safe and convenient method of surgical access for implant fixture installation, with the advantage of rebuilding the vestibule of a compromised atrophic ridge in the anterior mandible.

Vestibuloplasty: Porcine Collagen Matrix Versus Free Gingival Graft: A Clinical and Histologic Study

“…In general, this surgical procedure is primarily used to optimize the jaws for prosthesis integration 5,6 . The secondary objective of a vestibuloplasty might be to increase the height of the residual alveolar ridge, in cases of bony atrophy, or to generate a sufficient band of keratinized mucosa around teeth or dental implants 7‐9 …”

“…5,6 The secondary objective of a vestibuloplasty might be to increase the height of the residual alveolar ridge, in cases of bony atrophy, or to generate a sufficient band of keratinized mucosa around teeth or dental implants. [7][8][9] A free gingival graft (FGG) from the palate is currently the gold standard for augmenting small areas of keratinized mucosa. 10,11 No satisfactory results were found with autologous transplants derived from tissues other than palatal mucosa.…”

Long‐term outcomes after vestibuloplasty with a porcine collagen matrix (Mucograft®) versus the free gingival graft: a comparative prospective clinical trial

“…This surgical procedure is primarily used to optimize the jaws for prosthesis integration (Edlan 1954;Hillerup & Solow 1990;Costello et al 1996). The secondary objective is to increase the height of the residual alveolar ridge or to generate a sufficient band of keratinized mucosa around teeth or dental implants (Kao et al 2002;Cillo & Finn 2009;Heberer & Nelson 2009). The current literature on the role of periimplant tissue is conclusive to support augmenting peri-implant soft tissues or increasing the width of peri-implant keratinized mucosa (Esposito et al 2007).…”

The association between shallow vestibular depth and peri‐implant parameters: a retrospective 6 years longitudinal study

“…), with or without the combination of a vestibuloplasty (Kao et al. , Cillo & Finn , Heberer & Nelson ), and trans‐alveolar sutures to secure the buccal and lingual flaps apically to a fixed and stable bony anchorage (Altiparmak & Uckan , Deeb et al. ).…”

“…These surgical procedures have been used also adjacent to dental implants to improve their long-term prognosis. These include free gingival grafts (Artzi et al 1993, Melo et al 2008, with or without the combination of a vestibuloplasty (Kao et al 2002, Cillo & Finn 2009, Heberer & Nelson 2009), and trans-alveolar sutures to secure the buccal and lingual flaps apically to a fixed and stable bony anchorage (Altiparmak & Uckan 2013, Deeb et al 2015. These techniques increase both keratinized mucosa width and vestibular depth, and decrease subsequent mobility of the buccal and lingual flaps in a coronal direction after implant placement.…”