Efficacy of Labial Split-Thickness Eversion Periosteoplasty for Soft Tissue Management in Posterior Mandibular...

Area of Science:

• Oral and Maxillofacial Surgery
• Regenerative Medicine
• Periodontology

Background:

• Horizontal ridge augmentation in the posterior mandible is crucial for dental implant placement.
• Achieving adequate soft tissue closure over bone grafts can be challenging.
• The bone shell onlay grafting technique is used for lateral bone augmentation.

Purpose of the Study:

• To evaluate the efficacy of split-thickness labial eversion periosteoplasty (EPP) for soft tissue closure.
• To assess wound healing and complication rates following mandibular horizontal ridge augmentation using EPP.

Main Methods:

• A prospective study involving 16 patients with 18 posterior mandibular bone defects.
• Lateral onlay bone grafting using the bone shell technique followed by EPP for soft tissue closure.
• Wound healing was evaluated using a modified scoring index and visual analog scale (VAS) for pain and swelling.

Main Results:

• The summarized wound healing score significantly improved from day 2 to day 7 and reached optimal scores by 1 month.
• No cases of wound dehiscence or incomplete incision closure were observed.
• Postoperative pain and swelling significantly decreased by day 7 and resolved by 1 month.

Conclusions:

• Split-thickness labial EPP facilitates flap advancement for tight soft tissue coverage in extensive mandibular bone augmentations.
• The technique, though surgically demanding, can significantly reduce the postoperative complication rate.
• Offset double-layer wound closure contributes to successful outcomes in posterior mandibular horizontal ridge augmentation.