head JofIMAB
Journal of IMAB - Annual Proceeding (Scientific Papers)
Publisher: Peytchinski Publishing Ltd.
ISSN: 1312-773X (Online)
Issue: 2021, vol. 27, issue2
Subject Area: Dental Medicine
DOI: 10.5272/jimab.2021272.3812
Published online: 14 June 2021

Case report

J of IMAB. 2021 Apr-Jun;27(2):3812-3816
Tasho GavrailovORCID logo Corresponding Autoremail, Ivan ChenchevORCID logo,
Department of Oral Surgery, Faculty of Dental Medicine, Medical University - Plovdiv, Bulgaria.

Purpose: The aim of this research was to evaluate the cumulative effect of using both epithelial autograft and xenogeneic collagen matrix as an alternative to single keratinized epithelial palatal autografts, which can prove beneficial for its reduced morbidity.
Materials and methods: This study includes one female patient with an extremely atrophic mandible who requires deepening of the vestibulum in the anterior region in order to improve the stability of the removable denture. The surgical procedure included local anesthesia, one horizontal incision and a partial-thickness flap elevation. The exposed periosteum was covered by a small keratinized epithelial autograft from the hard palate at its apical aspect and a xenogeneic collagen matrix at its coronal portion. Follow up of the healing process was performed on the 7th, 14th, 30th day, after three and six months.
Results: The postoperative period underwent without any complications in all areas. The healing process resulted in the formation of an additional area of keratinized mucosa - a mean gain value of 2.92 mm after six months, which led to a significant improvement of denture stability.
Conclusion: The final result suggested that this technique shows great promise in compensating the disadvantages of using single grafting materials: the increased morbidity caused by the additional surgical site on the palate in the case of autografts and the greater shrinkage of the area of keratinized mucosa in a six months period when collagen matrixes are applied as a single grafting material in large edentulous areas.

Keywords: Vestibuloplasty, free epithelial graft, collagen matrix,

pdf - Download FULL TEXT /PDF 1644 KB/
Please cite this article as: Gavrailov T, Chenchev I. Vestibuloplasty in an extremely atrophic edentulous mandible using a combination of strip palatal graft and xenogeneic collagen matrix: A case report. J of IMAB. 2021 Apr-Jun;27(2):3812-3816. DOI: 10.5272/jimab.2021272.3812

Corresponding AutorCorrespondence to: Tasho Gavrailov, Department of Oral Surgery, Faculty of Dental Medicine, Medical University – Plovdiv; 3, Hristo Botev Str., Plovdiv, Bulgaria; E-mail: tasho.gavrailov@gmail.com

1. Atanasov D. (Editor). [Oral surgery.] [in Bulgarian] Tafprint, Plovdiv. 2011: 255-259.
2. Ivanova V, Chenchev I, Gavrailov T. Clinical Comparison of Three Methods for Vestibuloplasty in the Anterior Part of the Mandibule. J of IMAB. 2018 Oct-Dec;24(4):2223-2227. [Crossref]
3. Archer MD. Discussion. In: Electrochemistry in Research and Development. Kalvoda R, Parsons R. (authors) Springer, USA. 1985. pp.49-51. [Internet]
4. Kelsey CC. Alveolar bone resorption under complete dentures. J Prosthet Dent. 1971 Feb;25(3):152-61. [PubMed]
5. de Koomen HA. A prosthetic view on vestibuloplasty with free mucosal graft. Int J Oral Surg. 1977 Feb;6(1):38-41. [PubMed]
6. Clark HB Jr. Deepening of labial sulcus by mucosal flap advancement. J Oral Surg (Chic). 1953 Apr;11(2):165-8. [PubMed]
7. Amphlett J, Colwell WC. Edentulous vestibuloplasty using the palatal graft technique. J Prosthet Dent. 1982 Jul;48(1):8-14. [PubMed]
8. Huybers TJ, Stoelinga PJ, De Koomen HA, Tideman H. Mandibular vestibuloplasty using a free mucosal graft. A 2-7 year evaluation. Int J Oral Surg. 1985 Feb;14(1):11-5. [PubMed]
9. Cawood JI, Stoelinga PJ, Blackburn TK. The evolution of preimplant surgery from preprosthetic surgery. Int J Oral Maxillofac Surg. 2007 May;36(5):377-85. [PubMed]
10. Ghanaati S. Non-cross-linked porcine-based collagen I-III membranes do not require high vascularization rates for their integration within the implantation bed: a paradigm shift. Acta Biomater. 2012 Aug;8(8):3061-72. [PubMed]
11. Herford AS, Akin L, Cicciu M, Maiorana C, Boyne PJ. Use of a porcine collagen matrix as an alternative to autogenous tissue for grafting oral soft tissue defects. J Oral Maxillofac Surg. 2010 Jul;68(7):1463-70. [PubMed]
12. Lim HC, An SC, Lee DW, Lee DW. A retrospective comparison of three modalities for vestibuloplasty in the posterior mandible: apically positioned flap only vs. free gingival graft vs. collagen matrix. Clinical Oral Investigations. 2018 Jun;22(5):2121-2128. [PubMed]
13. Mahajan M, Gupta MK, Bande C, Meshram V. Comparative Evaluation of Healing Pattern After Surgical Excision of Oral Mucosal Lesions by Using Platelet-Rich Fibrin (PRF) Membrane and Collagen Membrane as Grafting Materials-A Randomized Clinical Trial. J Oral Maxillofac Surg. 2018;76(7):1469.e1-1469.e9. [PubMed]
14.  Maiorana C, Pivetti L, Signorino F, Grossi GB, Herford AS, Beretta M. The efficacy of a porcine collagen matrix in keratinized tissue augmentation: a 5-year follow-up study. Int J Implant Dent. 2018 Jan 10;4(1):1. [PubMed]
15. Schmitt CM, Moest T, Lutz R, Wehrhan F, Neukam FW, Schlegel KA. Long-term outcomes after vestibuloplasty with a porcine collagen matrix (Mucograft®) versus the free gingival graft: a comparative prospective clinical trial. Clin Oral Implants Res. 2016;27(11):125-133. [PubMed]
16. Rastogi S, Modi M, Sathian B. The efficacy of collagen membrane as a biodegradable wound dressing material for surgical defects of oral mucosa: a prospective study. J Oral Maxillofac Surg. 2009 Aug;67(8):1600-6. [PubMed]
17. Preidl RHM, Wehrhan F, Weber M, Neukam FW, Kesting M, Schmitt CM. Collagen Matrix Vascularization in a Peri-Implant Vestibuloplasty Situation Proceeds Within the First Postoperative Week. J Oral Maxillofac Surg. 2019 Sep;77(9):1797-1806. [PubMed]
18. Thoma DS, Alshihri A, Fontolliet A, Hämmerle CHF, Jung RE, Benic GI. Clinical and histologic evaluation of different approaches to gain keratinized tissue prior to implant placement in fully edentulous patients. Clin Oral Investig. 2018 Jun;22(5):2111-2119. [PubMed]
19.Urban IA, Lozada JL, Nagy K, Sanz M. Treatment of severe mucogingival defects with a combination of strip gingival grafts and a xenogeneic collagen matrix: a prospective case series study. Int J Periodontics Restorative Dent. 2015 May-Jun;35(3):345-53. [PubMed]
20. Tarasenko S, Ashurko I, Taschieri S, Repina S, Esaya N A, Corbella S. Comparative analysis of methods to increase the amount of keratinized mucosa before stage-two surgery: a randomized controlled study. Quintessence Int. 2020; 51(5):374-387. [PubMed]
21. Meitner S, Papadimitriou D, Kotsailidi EA, Habibzadeh M, Chochlidakis K, Ercoli C, et al. An alternative approach for vestibular extension using temporary coverage of epithelialized palatal grafts. Quintessence Int. 2020; 51(4):286-292. [PubMed]

Received: 30 July 2020
Published online: 14 June 2021

back to Online Journal