Díaz JE, García AF, Gómez FM, Fontes GZ

Language: Spanish
References: 33
Page: 20-28
PDF size: 404.04 Kb.

ABSTRACT

Dental extraction is a very common procedure in dentistry. Osseous healing and soft tissue healing after the extraction, is produced with a certain degree of alveolar atrophy and modifications in the soft tissues also occur. Bone healing involves resorption and alveolar bone growth in the bucco-lingual and apico-coronal dimensions. To facilitate treatments after the extraction (like implant placement), it is required to maintain hard and soft tissue and stabilize the alveolar process volume. Procedures that aim to accomplish these characteristics exist. Alveolar process preservation techniques focus on reducing horizontal and vertical osseous resorption after an extraction. Osseous substitutes such as allogenic or xenogeneic grafts are used. The subepithelial connective tissue pedicle palatal flap was described by Wang et al. (1993) and by Nemcovsky & Artzi (1999). This flap permits the correction of defects in width and height and consists of a connective tissue strip that is separated from the palatal vault and rotated over the defect. The donor site is covered by the remaining epithelial portion of the palate flap. The purpose of this case is to present generalities, relevance, indications, advantages and disadvantages of the procedure and its complimentary efficacy to maxillary alveolar ridge preservation techniques.

REFERENCES

1. Medina-Solís CE, Pontigo-Loyola AP, Pérez-Campos E, Hernández-Cruz P, De la Rosa-Santillana R, Navarete-Hernández JJ et al. Principales razones de extracción de dientes permanentes en una muestra de adultos mexicanos. Rev Invest Clin. 2013; 65 (2): 141-149.

2. Ávila Ortiz G, Chambrone L, Vignoletti F. Effect of alveolar ridge preservation interventions following tooth extraction: a systematic review and meta-analysis. J Clin Periodontol. 2019; 46 (21): 195-223.

3. Tan WL, Wong TL, Wong MC, Lang NP. A systematic review of post-extractional alveolar hard and soft tissue dimensional changes in humans. Clin Oral Implants Res. 2012; 23 (5): 1-21.

4. Yilmaz S, Efeoglu E, Kilic AR. Alveolar ridge reconstruction and/or preservation using root form bioglass cones. J Clin Periodontol. 1998; 25 (10): 832-839.

5. Artzi Z, Tal H, Dayan D. Porous bovine bone mineral in healing of human extraction sockets. Part 1: histomorphometric evaluations at 9 months. J Periodontol. 2000; 71 (6): 1015-1023.

6. Brugnami F, Caiazzo A. Efficacy evaluation of a new buccal bone plate preservation technique: a pilot study. Int J Periodontics Restorative Dent. 2011; 31 (1): 67-73.

7. Lekovic V, Camargo PM, Klokkevold PR, Weinlaender M, Kenney EB, Dimitrijevic B et al. Preservation of alveolar bone in extraction sockets using bioabsorbable membranes. J Periodontol. 1998; 69 (9): 1044-1049.

8. Iasella JM, Greenwell H, Miller RL, Hill M, Drisko C, Bohra AA et al. Ridge preservation with freeze-dried bone allograft and a collagen membrane compared to extraction alone for implant site development: a clinical and histologic study in humans. J Periodontol. 2003; 74 (7): 990-999.

9. García S, Molina J, Galve A, Hernández F. Usefulness of subepithelial connective tissue pedicled palatal flap in alveolar reconstruction: A report of case series. J Indian Soc Periodontol. 2022; 26: 287-294.

10. Babbush CA. Histologic evaluation of human biopsies after dental augmentation with a demineralized bone matrix putty. Implant Dent. 2003; 12 (4): 325-332.

11. Carmagnola D, Adriaens P, Berglundh T. Healing of human extraction sockets filled with Bio-Oss. Clin Oral Implants Res. 2003; 14 (2): 137-143.

12. Froum S, Cho SC, Elian N, Rosenberg E, Rohrer M, Tarnow D. Extraction sockets and implantation of hydroxyapatites with membrane barriers: a histologic study. Implant Dent. 2004; 13 (2): 153-164.

13. Wang PD, Pitman DP, Jans HH. Ridge augmentation using a subepithelial connective tissue pedicle graft. Pract Periodontics Aesthet Dent. 1993; 5 (2): 47-51; quiz 52.

14. Nemcovsky CE, Artzi Z. Split palatal flap. I. A surgical approach for primary soft tissue healing in ridge augmentation procedures: technique and clinical results. Int J Periodontics Restorative Dent. 1999; 19 (2): 175-181.

15. Khoury F, Happe A. The palatal subepithelial connective tissue flap method for soft tissue management to cover maxillary defects: A clinical report. Int J Oral Maxillofac Implants. 2000; 15: 415-418.

16. García S, Molina J, Lázaro A, Aboul-Hosn S, Hernández F. Aumento de tejidos blandos mediante colgajo rotado pediculado subepitelial de paladar. A propósito de un caso. Periodoncia Clínica. 2017; 1: 27-35.

17. Sclar AG. The vascularized interposition periosteal-connective tissue (VIP-CT) flap. In: Sclar AG, editor. Soft tissues and esthetic considerations in implant therapy. Kimberly Drive: Quintessence Books; 2003. pp. 163-187.

18. Agarwal C, Deora S, Abraham D, Gaba R, Kumar BT, Kudva P. Vascularized interpositional periosteal connective tissue flap: A modern approach to augment soft tissue. J Indian Soc Periodontol. 2015; 19: 72-77.

19. Balakrishnan, Ebenezer V, Prakash. Buccal & palatal advancement flap in post extraction. Eur J Mol Clin Med. 2020; 7 (5): 1585-1588.

20. García R, Egas LS, Carneiro P, Farnezi AP, Ávila F, Ponzoni D. Mucous retention cyst in maxillary sinus expansion of maxillary tuberosity: case report. J Oral Diag. 2018; 3: 1-7.

21. Donizeth-Rodrigues C, Fonseca-Da Silveira M, Goncalves-De Alencar AH, Garcia-Santos-Silva MA, Francisco-De-Mendonca E, Estrela C. Three-dimensional images contribute to the diagnosis of mucous retention cyst in maxillary sinus. Med Oral Patol Oral Cir Bucal. 2013; 18 (1): e151-e157.

22. Liu CL, Weisgold AS. Connective tissue graft: A classification for incision design from the palatal site and clinical case reports. Int J Periodontics Restorative Dent. 2002; 22: 373-379.

23. Rosenquist B. A comparison of various methods of soft tissue management following the immediate placement of implants into extraction sockets Int J Oral Maxillofac Implants. 1997; 12: 43-51.

24. Martinez-Garcia A, Bueno JM. Incisive vessel-based palatal flap for the reconstruction of anterior maxillary soft tissues. Int J Periodontics Restorative Dent. 2011; 31: 83-89.

25. Reiser GM, Bruno JF, Mahan PE, Larkin LH. The subepithelial connective tissue graft palatal donor site: Anatomic considerations for surgeons. Int J Periodontics Restorative Dent. 1996; 16: 130-137.

26. Orsini M, Orsini G, Benlloch D, Aranda JJ, Lázaro P, Sanz M. Esthetic and dimensional evaluation of free connective tissue grafts in prosthetically treated patients: A 1-year clinical study. J Periodontol. 2004; 75: 470-477.

27. Simion M, Trisi P, Piattelli A. Vertical ridge augmentation using a membrane technique associated with osseointegrated implants. Int J Periodontics Restorative Dent. 1994; 14: 496-511.

28. Buser D, Dula K, Hirt HP, Schenk RK. Lateral ridge augmentation using autografts and barrier membranes: A clinical study with 40 partially edentulous patients. J Oral Maxillofac Surg. 1996; 54: 420-432.

29. Goldstein M, Boyan BD, Schwartz Z. The palatal advance flap: A pedicle flap for primary coverage of immediately placed implants. Clin Oral Impl Res. 2002; 13: 644-550.

30. Langer B, Langer L. Subepithelial connective tissue graft technique for root coverage. J Periodontol. 1985; 56: 715-720.

31. Langer B, Calagna LJ. The subepithelial connective tissue graft. A new approach to the enhancement of anterior cosmetics. Int J Periodontics Restorative Dent. 1982; 2: 22-33.

32. Kim SB, Yun PY, Kim YK. Clinical evaluation of sinus bone graft in patients with mucous retention cyst. Maxillofac Plast Reconstr Surg. 2016; 38 (1): 35.

33. Anitua E, Alkhraisat MH, Torre A, Eguía A. Are mucous retention cysts and pseudocysts in the maxillary sinus a risk factor for dental implants? A systematic review. Med Oral Patol Oral Cir Bucal. 2021; 26 (3): 276-283.