A method using vestibulo-sulcoplasty combining a split-thickness skin graft and a palatal keratinized mucosa graft for peri-implant tissue secondary to oral cancer surgery.
Twelve patients presented with oral submucosal fibrosis and loss of keratinized gingiva in a compromised vestibule of a severely deficient mandibular edentulous ridge secondary to oral cancer surgery. They received implant rehabilitation with a total of 49 fixtures without major bone graft augmentation. To overcome vestibular compromise, soft tissue management consisting of simultaneous vestibulo-sulcoplasty, split-thickness skin graft (STSG), and palatal keratinized mucosa graft (KMG) was performed as a second stage when healing abutment was transferred to replace the cover screw of the dental implant. Postoperative follow-up of all patients consisted of clinical and radiographic examinations for an average of 4 years, revealing good stability of implant fixtures with a 91.8% success rate and generally healthy peri-implant tissue, the latter with an average sulcus depth of 2.9 +/- 0.6 mm. Satisfactory results were also demonstrated regarding improved morphology of the vestibule, cosmetics, and prosthetic functionality. Vestibulo-sulcoplasty combining STSG and palatal KMG offers a stable and convenient method for rebuilding peri-implant tissue without need for bone grafting in selected patients who have compromised atrophic ridges secondary to cancer surgery.
Kao
Shou-Yen
SY
Oral and Maxillofacial Surgery, Department of Dentistry, Taipei Veterans General Hospital, Taipei, Taiwan, ROC. sykao@vghtpe.gov.tw
Lui
Man-tin
MT
Fong
Jenny
J
Wu
Dmsc Che-wei
DC
Wu
Cheng-Hsien
CH
Tu
Hsi-Feng
HF
Hung
Kai-Feng
KF
Yeung
Tze-Cheung
TC
D016301:Alveolar Bone Loss / Q000209:etiology / Q000534:rehabilitation*; D002294:Carcinoma, Squamous Cell / Q000534:rehabilitation / Q000601:surgery; D003758:Dental Implantation, Endosseous / Q000379:methods*; D005260:Female; D006801:Humans; D007575:Jaw, Edentulous / Q000209:etiology / Q000534:rehabilitation*; D008297:Male; D008334:Mandible / Q000601:surgery*; D008875:Middle Aged; D009061:Mouth Mucosa / Q000637:transplantation; D009062:Mouth Neoplasms / Q000534:rehabilitation* / Q000601:surgery; D009914:Oral Submucous Fibrosis / Q000209:etiology / Q000534:rehabilitation; D019647:Oral Surgical Procedures / Q000009:adverse effects*; D016038:Skin Transplantation; D014727:Vestibuloplasty / Q000379:methods*