Periosteal Fenestration Procedure in Apically Positioned Flap Increases the Attached Mucosal Width: An In Vivo...

Area of Science:

• Periodontology
• Oral surgery
• Tissue engineering

Background:

• Increasing masticatory mucosa (MM) width is crucial for periodontal health and implant stability.
• The apically positioned flap (APF) technique is commonly used, but its efficacy in conjunction with periosteal fenestration requires further evaluation.

Purpose of the Study:

• To assess the efficacy of APF with periosteal fenestration in augmenting MM width.
• To histologically characterize the newly gained MM tissue.

Main Methods:

• A split-mouth study in six dogs compared APF alone (control) versus APF with periosteal fenestration (test).
• Clinical and digital measurements of MM width were taken at baseline, post-operatively, and after 8 weeks.
• Histological analysis evaluated the distance from the free gingival margin to the mucogingival junction and the width of non-keratinized attached mucosa (NKAM).

Main Results:

• The fenestration group showed a significantly greater mean gain in clinical MM width (4.27 mm) compared to the control group (3.17 mm).
• Histological analysis revealed that the increased mucosal width in the fenestration group was primarily composed of non-keratinized epithelium.

Conclusions:

• Apically positioned flap with periosteal fenestration is effective in increasing masticatory mucosa width.
• The enhanced width achieved is predominantly non-keratinized attached mucosa, not orthokeratinized tissue.