Portal de Periódicos da CAPES

Resorption of the edentulous mandible after a vestibuloplasty with skin grafting

1983; Elsevier BV; Volume: 49; Issue: 5 Linguagem: Inglês

10.1016/0022-3913(83)90383-9

1097-6841

Howard M. Landesman, W. Howard Davis, James T. Martinoff, Ronald M. Kaminishi,

Reconstructive Surgery and Microvascular Techniques

T, Id rote ures to improve the basal seat for an inadequately supported mandibular complete denture have been attempted from the time dentists began replacing natural dentition with artificial removable prostheses. As early as 1874 Thiersch’ described a technique of using epidermal grafting. This appears to have stimulated others to expand the technique and develop the skin grafting vestibuloplasty and lowering of the floor of the mouth (VSG and LFM) procedure.2-‘4 Research indicates that the VSG and LFM procedure is an effective treatment modality for patients who complain of an ill fitting denture, poor masticatory function, and pain. l5 The purpose of the VSG and LFM is to create a larger basal area of fixed epithelium for improved stability and support of the prosthesis. The procedure is an apparent improvement over other techniques because it offers several benefits, such as: (1) fixed tissue on which the denture rests allows stability during mastication and speech; (2) lengthening of the denture flanges, which provides a broader denture base to more widely distribute occlusal forces; (3) enhancing patient comfort, as the skin is a better stress-bearing tissue than mucosa; and (4) longevity of the result. Because VSG and LFM repositions muscle attachments, the question arises as to whether the mandibular resorption following this procedure is more rapid than in the untreated mandible. Hillerup,16 in a survey of 15 patients following a vestibular sulcus extension using the technique of Edlan and Mejchar,“~“’ reported that the procedure fails to protect alveolar bone and may even provoke accelerated bone resorption. However, the procedure of Edlan and Mejchar does not incorporate the use of a skin graft in conjunc-