The versatile "lip switch" or transitional flap vestibuloplasty combined with alveoloplasty and implant placement to treat atrophic mandibles with inadequate vestibules and attached tissue: A case series and review of the literature

Spec Care Dentist. 2021 Jan;41(1):78-84. doi: 10.1111/scd.12546. Epub 2020 Dec 3.

Abstract

Introduction/aims: The edentulous mandibular ridge and associated shallow vestibule are often seen as a challenge in the oral rehabilitation of patients. Dental implants can provide an improvement in mastication and patient satisfaction. The aim of this study is to utilize a preprosthetic mucosal flap combined with a repositional periosteal flap concomitant with an alveoloplasty and placement of endosteal implants as a single-stage procedure in the anterior mandible. This approach provides a valued alternative for dental rehabilitation in patients with poor masticatory efficiency using a conventional denture.

Methods: Eight patients underwent the preprosthetic surgical plan in the oral surgery clinic of the dental school during a 1-year period. Age, sex, preoperative, and postoperative vestibular depth, as well as hard and soft tissue elements were measured (P < .05) at 4-6 months.

Results: Mean age was 53 years ± 14.62 (N = 8). Anterior mandible height was 19 ± 4.8 mm. A significant difference was measured using a two-tailed Student's t-test between pre- and postoperative vestibular depths, respectively (3.9 mm vs 10.5 ± 0.96 mm; P < .01).

Conclusions: A lip switch vestibuloplasty combined with placement of two implants provide a one-stage procedure that is convenient, provides a shorter postoperative period, and can be financially affordable. Future research requires larger sampling to support this treatment as a standard of care.

Keywords: dental implants; edentulous mandible; preprosthetic surgery; ridge augmentation; vestibuloplasty.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Alveoloplasty
  • Dental Implantation, Endosseous
  • Dental Prosthesis, Implant-Supported
  • Humans
  • Infant
  • Jaw, Edentulous* / surgery
  • Lip
  • Mandible / surgery
  • Middle Aged
  • Vestibuloplasty*