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A retrospective comparison of three modalities for vestibuloplasty in the posterior mandible: apically positioned flap only vs. free gingival graft vs. collagen matrix

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Abstract

Objectives

This work aimed to comparatively evaluate the three modalities of vestibuloplasty around implants in the posterior mandible.

Materials and methods

Forty patients who presented with a shallow vestibule and insufficient keratinized gingiva were divided into three groups: apically positioned flap only (APF group), APF with free gingival graft (FGG group), and APF with collagen matrix (CM group). The width of KT was measured at baseline, immediately after surgery (T0), and 6 months (T6) and 12 months after surgery (T12). An esthetic evaluation (color match, contour, and texture) was conducted.

Results

Most of the shrinkage occurred within 6 months. The FGG group demonstrated less shrinkage of KT up to 12 months compared to the APF and CM groups. The APF and CM groups exhibited a prolonged and similar rate of shrinkage. The APF and CM groups also showed significantly better esthetic profiles.

Conclusions

Within the limitations of the present study, FGG may be the most predictable modality for increasing KT in the posterior mandible, but it should be emphasized that the posterior mandible does not require high esthetics.

Clinical relevance

The effect of apically positioned flap and collagen matrix may be diminished by several factors in posterior mandible, such as low vestibule and high muscle pull. For increasing the dimension of keratinized tissue in posterior mandible, conventional free gingival graft may be more predictable compared to other options.

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Funding

This study was supported by a Veterans Health Service Medical Center Research Grant, Republic of Korea (Grant number: VHSMC 17022).

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Author notes

  1. Hyun-Chang Lim and Sang-Chun contributed equally to this work.

Authors and Affiliations

  1. Department of Periodontology, Periodontal-Implant Clinical Research Institute, Kyung Hee University Dental Hospital, Seoul, South Korea

    Hyun-Chang Lim

  2. Department of Periodontology, Veterans Health Service Medical Center, 53 Jinhwangdo-ro 61-gil, Gangdong-gu, Seoul, 05368, South Korea

    Sang-Chun An & Dong-Woon Lee

Authors
  1. Hyun-Chang Lim
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  2. Sang-Chun An
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Corresponding author

Correspondence to Dong-Woon Lee.

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Conflicts of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The present study was approved by the ethics committee of the Veteran Health Service Medical Center (approval no. 2016-09-018).

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For this type of study, formal consent is not required.

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Lim, HC., An, SC. & Lee, DW. A retrospective comparison of three modalities for vestibuloplasty in the posterior mandible: apically positioned flap only vs. free gingival graft vs. collagen matrix. Clin Oral Invest 22, 2121–2128 (2018). https://doi.org/10.1007/s00784-017-2320-y

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  • DOI: https://doi.org/10.1007/s00784-017-2320-y

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