J Korean Assoc Oral Maxillofac Surg.  2019 Dec;45(6):369-373. 10.5125/jkaoms.2019.45.6.369.

Vestibuloplasty covering titanium mesh with grafted free gingiva on anterior mandible: technical report and rationale

• Ku JK
• Leem DH

• KMID: 2467190
• DOI: http://doi.org/10.5125/jkaoms.2019.45.6.369

Abstract

This paper describes a patient with an insufficient vestibular depth for a removable partial denture who underwent vestibuloplasty with a free gingival graft using a titanium mesh in the anterior mandible. Free gingiva was harvested from the palatal mucosa, and a partial thickness flap was elevated at the recipient site. After minimal suturing for the graft, a titanium mesh was fixed over the graft. The mesh was removed four weeks after surgery. The patient obtained an adequate vestibular depth and keratinized gingiva eight weeks after surgery without any complications. In this case, an appropriate vestibular depth and keratinized gingiva were easily obtained by vestibuloplasty using a titanium mesh.

Keyword

Gingiva; Removable partial denture; Titanium; Vestibuloplasty

MeSH Terms

Denture, Partial, Removable
Gingiva*
Humans
Mandible*
Mucous Membrane
Titanium*
Transplants*
Vestibuloplasty*
Titanium

Figure

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  Fig. 1 Lack of vestibular depth due to scar constriction. A, B. The vestibular depth was insufficient for a removable partial denture.

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  Fig. 2 Surgical procedure. A. Recipient site preparation with partial thickness flap elevation. B. Suturing of the free gingival grafts (1×2 cm, from the palatal gingiva) onto the recipient periosteum. C. Adaptation of the titanium meshes with miniscrews.

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  Fig. 3 Titanium mesh removal at four weeks after surgery. A. Excessive soft tissue growth covering the mesh. B. Curettage for removal of the soft tissue. C. Removal of the mesh and miniscrews.

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  Fig. 4 Eight weeks after the operation (four weeks after mesh removal). Sufficient amounts of keratinized gingiva and vestibular depth were obtained.

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