Use of a 10,600-nm CO2 Laser Mandibular Vestibular Extension in a Patient With a Chromosomal Abnormality.

Vestibuloplasty involves a series of surgical procedures designed to restore alveolar ridge height by lowering the muscles attached to the buccal, labial, and lingual aspects of the jaws. The technique is indicated in cases of insufficient vestibular depth that may result from atrophy of the alveolar ridge and/or high attachment of muscle or movable mucosa. This article focuses on a carbon dioxide (CO2) laser vestibular extension procedure performed in a patient with Klinefelter syndrome, which is caused by a chromosomal abnormality. The 10,600-nm CO2 laser is shown to offer several advantages over a conventional scalpel and other laser wavelengths for soft-tissue pre-prosthetic surgery, including vestibular extension.

Development of stable peri-implant soft tissue and mentolabial sulcus depth with an implant-retained soft tissue conformer after osteocutaneous flap reconstruction.

Excessive soft tissue bulk, movement, chronic inflammation, and hypertrophy in periimplant areas pose challenges for long-term management of peri-implant soft tissues surrounding osteocutaneous flap reconstructions. A case history report is presented on the predictable establishment of stable peri-implant soft tissue and improved mentolabial sulcus depth in a patient treated for high-grade osteosarcoma of the mandible. Following surgical resection, reconstruction with osteocutaneous fibula free flap, and endosseous implant placement, a combined surgical and prosthetic approach was used through a lip switch vestibuloplasty and an implant-retained soft tissue conformer.

Soft tissue laser in orthodontics.

Today a lot of minor cosmetic surgery operations on the gingiva can easily be carried out directly by the orthodontist with a small quantity of topical anaesthetic and the use of a soft tissue laser. The Diode laser is the most commonly used laser in dentistry for minor surgery to the soft tissues. This kind of laser offers numerous advantages with respect to traditional or electric scalpels. In this article the authors will analyse several typical uses of the diode laser in daily orthodontic practice.

[Preprosthetic surgery of the edentulous maxilla: vestibular deepening with the aid of the CO2 laser]. / Chirurgie pré-prothétique de l'édenté maxillaire complet: approfondissement vestibulaire à l'aide du laser CO2.

Vestibular deepening for maxillary edentulous patients is mainly indicated once instability cannot be reached due to important bone resorption. Vestibular deepening with CO2 super-pulsed laser enhance, in a bloodless environment, sustentation as well retention of those full dentures in good operative conditions as compared with conventional techniques.

360 degrees peri-implant, keratinised, soft-tissue grafting with stereolithographic-aided dressing plate.

Surgical procedures to improve the quality of peri-implant soft tissue are a routine part of dental implant practice, especially in the edentulous patient with a significant lack of attached keratinised tissue. The use of a dressing plate at the recipient site can be beneficial in supporting free, keratinised, soft-tissue grafts during the early healing phase, especially if grafting is undertaken around all aspects of the implant and not just to the facial section. This paper outlines the use of a dressing plate, constructed on a stereolithographic model, for use at second-stage implant surgery to allow for 360 degrees peri-implant, keratinised, soft-tissue grafting.

Comparative evaluation of two different vestibuloplasty surgical procedures in cleft patients: a pilot study.

OBJECTIVE: Patients with a cleft lip or palate often present alterations in the labial aspect of the ridge, resulting in a shallow vestibule. This study compares the results of two different surgical procedures on deepening of the labial sulcus. INTERVENTIONS: Ten patients with a cleft lip and palate were separated into two groups and underwent different vestibuloplasty procedures. An experimental group used a removable retention splint. Preoperative and 4-month postoperative sulcus heights were measured and analyzed statistically. RESULTS: No statistically significant differences could be detected between groups. CONCLUSION: The results indicated that to reach consistent results, a larger number of patients must be submitted to this evaluation.

The "Loma Linda stent": a screw-retained resin stent.

This article describes a technique in which an acellular dermal allograft is used in combination with a photopolymerized acrylic resin stent to increase the zone of keratinized tissue around osseointegrated dental implants. During the second-stage surgery, a split thickness labial flap is reflected and apically repositioned by being sutured onto the periosteum and connective tissue. The acellular dermal allograft is then sutured onto the recipient site. The acrylic resin is trimmed and secured with temporary abutments to the implants, fitting passively over the graft and then photopolymerized intraorally. The stent is left for 1 week to secure the graft in place. This technique offers an alternative mucogingival procedure for increasing the zone of keratinized tissue around osseointegrated dental implants.

Mandibular vestibuloplasty and gingival grafts using impacted posts.

In the presence of an atrophic endentulous mandible, the stability of the mandibular denture is related to the quality of the osteomucosal support and the muscles surrounding it. A new procedure for vestibuloplasty is described that combines a periosteal flap and a gingival graft. Titanium impacted posts are used for fixation and the stabilization of the flap and graft. This clinical report presents the results for 12 patients. Clinical appraisal indicates that the technique appears to improve the anteroposterior stability of the mandibular denture, increasing the attached mucosa and offering better long-term results. The management of the gingival and muscular environment can improve the peri-implant area.

[Vestibuloplasty with Kirschner wire fixation]. / Vestibulumplastik mit Kirschner-Draht-Fixation.

We present a new method of fixation for creation of the vestibular sulcus in cases of open or closed submucous vestibuloplasty. Kirschner-wires (diameter 0.5 mm) are drilled through the mucous membrane into the bone. The wires keep the hand cut oval elastic sheets in place to adapt the mucous membrane to the periosteum at the deepest point of the vestibule respectively. Advantages of the method in comparison to other fixation techniques are discussed.

Vestibulo-lingual sulcoplasty with skin graft in the mandible.

A surgical technique for vestibulo-lingual sulcoplasty in the mandible is described. The lingual bone surface is entirely covered by a mucoperiosteal flap, when the muscles have been cut and the lingual sulcus deepened. A split-thickness skin graft taken from the inner surface of the upper arm is placed vestibularly in the region 38--48. An essential increase of the denture-wearing area is obtained and the dislocating effect of the muscles on the denture is eliminated.