Anterior maxillary defect reconstruction with a staged bilateral rotated palatal graft
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Purpose: In the anterior maxilla, hard and soft tissue augmentations are sometimes requiredto meet esthetic and functional demands. In such cases, primary soft tissue closureafter bone grafting procedures is indispensable for a successful outcome. This report describesa simple method for soft tissue coverage of a guided bone regeneration (GBR) siteusing the double-rotated palatal subepithelial connective tissue graft (RPSCTG) techniquefor a maxillary anterior defect. Methods: We present a 60-year-old man with a defect in the anterior maxilla requiringhard and soft tissue augmentations. The bone graft materials were filled above the alveolardefect and a titanium-reinforced nonresorbable membrane was placed to cover the graftmaterials. We used the RPSCTG technique to achieve primary soft tissue closure over thegraft materials and the barrier membrane. Additional soft tissue augmentation using acontralateral RPSCTG and membrane removal were simultaneously performed 7 weeks afterthe stage 1 surgery to establish more abundant soft tissue architecture. Results: Flap necrosis occurred after the stage 1 surgery. Signs of infection or suppurationwere not observed in the donor or recipient sites after the stage 2 surgery. These proceduresenhanced the alveolar ridge volume, increased the amount of keratinized tissue, andimproved the esthetic profile for restorative treatment. Conclusions: The use of RPSCTG could assist the soft tissue closure of the GBR sites becauseit provides sufficient soft tissue thickness, an ample vascular supply, protection ofanatomical structures, and patient comfort. The treatment outcome was acceptable, despitemembrane exposure, and the RPSCTG allowed for vitalization and harmonization withthe recipient tissue.
Abstract
Purpose: In the anterior maxilla, hard and soft tissue augmentations are sometimes requiredto meet esthetic and functional demands. In such cases, primary soft tissue closureafter bone grafting procedures is indispensable for a successful outcome. This report describesa simple method for soft tissue coverage of a guided bone regeneration (GBR) siteusing the double-rotated palatal subepithelial connective tissue graft (RPSCTG) techniquefor a maxillary anterior defect. Methods: We present a 60-year-old man with a defect in the anterior maxilla requiringhard and soft tissue augmentations. The bone graft materials were filled above the alveolardefect and a titanium-reinforced nonresorbable membrane was placed to cover the graftmaterials. We used the RPSCTG technique to achieve primary soft tissue closure over thegraft materials and the barrier membrane. Additional soft tissue augmentation using acontralateral RPSCTG and membrane removal were simultaneously performed 7 weeks afterthe stage 1 surgery to establish more abundant soft tissue architecture. Results: Flap necrosis occurred after the stage 1 surgery. Signs of infection or suppurationwere not observed in the donor or recipient sites after the stage 2 surgery. These proceduresenhanced the alveolar ridge volume, increased the amount of keratinized tissue, andimproved the esthetic profile for restorative treatment. Conclusions: The use of RPSCTG could assist the soft tissue closure of the GBR sites becauseit provides sufficient soft tissue thickness, an ample vascular supply, protection ofanatomical structures, and patient comfort. The treatment outcome was acceptable, despitemembrane exposure, and the RPSCTG allowed for vitalization and harmonization withthe recipient tissue.
참고문헌 (39)
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