Vascularized connective tissue flap for bone graft coverage

Area of Science:

• Oral and Maxillofacial Surgery
• Periodontology
• Dental Implantology

Background:

• Alveolar defects often involve both hard and soft tissue loss, necessitating complex reconstructive procedures.
• Addressing soft tissue deficits frequently requires secondary surgical interventions.
• Current techniques may involve extensive soft tissue manipulation.

Purpose of the Study:

• To describe and evaluate a split-thickness flap technique for simultaneous bone and soft tissue reconstruction in alveolar defects.
• To assess the efficacy of this technique in increasing keratinized tissue and improving esthetics around implants.
• To determine the safety and predictability of the described flap design.

Main Methods:

• A split-thickness flap design, extended in a palatal direction, was utilized over autogenous bone grafts and osseointegrated implants.
• The technique was applied either primarily during bone grafting or secondarily during implant uncovering.
• Seventeen patients with anterior maxillary alveolar defects were included in the study.

Main Results:

• The split-thickness flap technique resulted in no flap necrosis or dehiscence, ensuring graft containment.
• All patients exhibited an increased zone of keratinized tissue in the peri-implant region.
• The procedure successfully restored both bone and keratinized tissue, enhancing esthetics and implant maintenance.

Conclusions:

• An apically repositioned split-thickness flap is an effective technique for reconstructing alveolar defects, providing adequate keratinized tissue.
• This method improves esthetic outcomes and facilitates long-term implant maintenance.
• The technique can be performed simultaneously with bone grafting, minimizing surgical invasiveness.