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.Abstract
Contributor Notes
Shou-Yen Kao, DDS, MHA, DMSc, is professor and chief of Oral and Maxillofacial Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, and is with the School of Dentistry, Central Clinic Hospital, National Yang-Ming University. Address correspondence to Dr Kao at No 201, Sec II, Shih-Pai Road, Oral and Maxillofacial Surgery, Department of Dentistry, Taipei Veterans General Hospital, Taipei, Taiwan, ROC (sykao@vghtpe.gov.tw).
Jenny Fong, DDS, DMSc, is an associate professor in the School of Dentistry, National Yang-Ming University, Taipei, Taiwan, ROC.
Man-Tin Lui, DDS, and Cheng-Hsien Wu, DDS, are attending physicians of Oral and Maxillofacial Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, and are with the School of Dentistry, National Yang-Ming University, Taipei, Taiwan, ROC.
Tze-Cheung Yeung, DDS, and Hsi-Feng Tu, DDS are attending physicians of Prosthetic Dentistry, Taipei Veterans General Hospital, Taipei, Taiwan, and is with the School of Dentistry, National Yang-Ming University, Taipei, Taiwan, ROC.
Che-Wei Wu, DDS, MS, and Kai-Feng Hung, DDS, MS, are residents of Oral and Maxillofacial Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, and are with the School of Dentistry, National Yang-Ming University, Taipei, Taiwan, ROC.