Clinical Evaluation of a Modified Method of Vestibuloplasty Using an Implant-Retained Splint

Purpose: Oral rehabilitation of resected tumor patients often requires, besides the use of dental implants, the improvement of the soft tissue condition. In this clinical report, we describe a simple and effective surgical and prosthetic treatment procedure to achieve adequate long-term soft tissue conditions. Materials and Methods: Seventeen tumor patients were selected for this evaluation. A total of 68 implants were placed in the mandible. At implant placement, a closed impression was taken from the implants for the fabrication of an implant-retained surgical split-it. At second-stage Surgery, vestibuloplasty by use of a split-thickness skin graft from the upper thigh was performed and in implant-retainted splint was positioned. Pocket depths at the implants and the size of the graft were monitored over a period of 2 years. Statistical analysis by use of nonparametric 2-factorial analyses for repeated measures was performed. Results: The mean mesial and distal pocket depths remained stable and measured 2.56 mm and 2.64 mm, respectively, at 24 months postoperatively. The graft showed an overall shrinkage of 18.5% in the vertical direction and 10.4% in the horizontal direction after 24 months. The shrinkage of the vertical direction compared with the horizontal direction showed a significant difference (P = .035). The shrinkage tendency was less than that described in the literature. Conclusions: The applied method described an easy, sufficient surgical procedure that minimizes shrinkage and creates a dent it re-bearing area that is stable over the long term, thus representing an improvement over previous methods. (C) 2009 American Association of Oral and Maxillofacial Surgeons