A new incision design for mandibular symphysis bone-grafting procedures.

ABSTRACT

BACKGROUND: Traditional methods of procuring mandibular symphysis bone grafts may leave soft tissue scarring, and cause paresthesia and lip droop. METHODS: Nineteen patients selected for treatment were given general health, periodontal, and radiographic evaluations. Patients had inadequate bone volume for dental implant placement or required preprosthetic ridge augmentation procedures. Prior to surgery, bone sounding was performed to determine tissue thickness. All patients had a minimum of 4 mm of keratinized gingiva. Under local anesthesia, incisions were initiated within the keratinized gingiva. Full-thickness mucoperiosteal flaps were elevated, and small burs were used to obtain bone blocks from the mandibular symphysis. A bone-scraping device was used to obtain strips of cortical bone. A combination of sling and interrupted sutures was used for wound closure. RESULTS: All patients healed uneventfully without wound dehiscence, paresthesia, or lip droop. Sufficient bone was obtained for ridge or sinus augmentation with eventual implant placement. CONCLUSIONS: A new incision design is presented. This flap design is carried out within keratinized gingiva. Limiting the flap design to keratinized tissue facilitates flap closure and avoids wound dehiscence.