Incision design in implant dentistry based on vascularization of the mucosa.
OBJECTIVE
The delivery of an adequate amount of blood to the tissue capillaries for normal functioning of the organ is the primary purpose of the vascular system. Preserving the viability of the soft tissue segment depends on the soft tissue incision being properly designed in order to prevent impairment of the circulation. A knowledge of the course of the vessels as well as of their supply area are crucial to the decision of the incision. The aim of this study was to visualize the course of the arteries using different techniques, to perform macroscopic- and microscopic analyses, and to develop recommendations for incisions in implant dentistry.


METHODS
The vascular systems of seven edentulous human cadavers were flushed out and filled with either red-colored rubber bond or Indian ink and formalin mixture. After fixation a macroscopic preparation was performed to reveal the course, distribution and supply area of the major vessels. In the area of the edentulous alveolar ridge specimens of the mucosa were taken and analyzed microscopically.


RESULTS
The analyses revealed the major features of mucosal vascularization. The main course of the supplying arteries is from posterior to anterior, main vessels run parallel to the alveolar ridge in the vestibulum and the crestal area of the edentulous alveolar ridge is covered by a avascular zone with no anastomoses crossing the alveolar ridge.


CONCLUSIONS
The results suggest midline incisions on the alveolar ridge, marginal incisions in dentated areas, releasing incisions only at the anterior border of the entire incision line, and avoidance of incisions crossing the alveolar ridge.
Kleinheinz
Johannes
J
Department of Cranio-Maxillofacial Surgery, University of Muenster, Muenster, Germany. joklein@uni-muenster.de
Büchter
André
A
Kruse-Lösler
Birgit
B
Weingart
Dieter
D
Joos
Ulrich
U
D002102:Cadaver; D002244:Carbon; D003758:Dental Implantation, Endosseous / Q000379:methods*; D006801:Humans; D007269:Injections, Intra-Arterial; D007575:Jaw, Edentulous / Q000601:surgery; D008334:Mandible / Q000098:blood supply* / Q000601:surgery; D008437:Maxilla / Q000098:blood supply* / Q000601:surgery; D009061:Mouth Mucosa / Q000098:blood supply* / Q000601:surgery
C028433:chinese ink; D002244:Carbon