변형된 Edlan-Mejchar 술식을 이용한 임플란트 주위 전정성형술의 기술적 측면에 대한 보고

Abstract

Vestibuloplasty is usually considered for improving retention and/or stability of denture by deepening vestibule and providing attached gingiva. The current case series aimed to describe the technical aspect of modified Edlan-Mejchar vestibuloplasty for improving the soft tissue environment around dental implants. The technique was applied to 3 patients who had a lack of vestibule and keratinized peri-implant mucosa. A U-shape incision that opens toward the implant prosthesis was performed 1 mm deep into the mucosa. It comprises of 2 vertical incisions that start 3 mm apical point from the buccal and proximal side of the implant and 1 horizontal incision that roundly connects the apical ends of the vertical incisions. Split-thickness flap was reflected on the mucosal area surrounded by the U-shape incision in the coronal direction. Another horizontal incision was performed under the flap into the periosteum along the imaginary line with the coronal edge of the U-shape. An underlying mucoperiosteal flap was reflected with dull instrument and apically positioned so that the superficial split-thickness flap could be placed on the denuded bone surface. The surgical wound was stabilized by suturing, gauze pressing, or periodontal dressing. The deepened vestibule and newly formed attached mucosa around implants were maintained in all patients during the follow-up period ranging from 3 to 9 months. The vestibular deepening with attached mucosa might be simply obtained using the technique in selected indications. However, further studies are warranted to investigate the long-term stability and histologic feature of the newly formed attached mucosa.