March 01, 2020
Vestibuloplasty procedure is carried out to enlarge the vestibule of the mouth. It is a surgical procedure in which ridge extension is done by deepening the space between the cheeks and the teeth. It consists of alteration in the membranes around the dental bone structure. It is also known as vestibule-sulcoplasty as it involves deepening the sulcus and does not disturb the bone structure.
Indications for vestibuloplasty
A certain amount of space is required for dentures to fit comfortably. Lack of proper fit not only causes discomfort, but also leads to chewing difficulties for the patient. Limited space within the oral cavity also makes it hard to maintain dental hygiene, leading to plaque build-up and infection.
People who have lost their natural teeth experience ridge resorption over time. This reduces the space available for dentures to rest on and fit comfortably. In such a situation Vestibuloplasty procedure is carried out to create more space within the mouth. It is necessary not only for full dentures but also for optimal stability of implants and partial dentures. It may be also required in cases where the membrane attach at the residual ridge crest making the vestibule too shallow. Sometimes this procedure is also carried out for reconstruction of gum pockets.
Cuts are made in the mucosa of the inner cheeks and inner lips which is then spread out to widen and deepen the vestibule. Various techniques of vestibuloplasty procedure are in prevalence and they can be broadly described as follows:
Mucosal advancement vestibuloplasty
The mucous membrane is undermined and spread to cover both sides and widen the vestibule. This technique can only be used when there is sufficient bone as well as enough pliable mucosa. Dentures are made and fitted about one month later.
Secondary epithilization vestibuloplasty
In cases where the bone structure is adequate but movable mucosa is either less than ideal in quantity or in quality, secondary epithilization is preferred. The undermined mucosa is used to cover one side while the other side heals with the development of fresh epithelial surface. The development of the new surface takes about 3 weeks, after which dentures are fabricated according to the new size of the oral cavity.
There are cases where even the bone structure is insufficient for the success of the vestibuloplasty procedure. In such a situation skin grafting becomes necessary to create enough denture bearing surface. Skin graft taken from hairless areas of the body is used to cover just one side or sometimes both the sides of the vestibule. Healing time is about 10 days only, but success depends on the quality of the recipient site. The site where the graft is to be placed should be free from infection and have a good blood supply.
Vestibuloplasty is a surgical procedure wherein cuts are made with a scalpel to extend the mucosa. However, laser technology is preferred nowadays as it reduces recovery time and leads to less scarring. As laser vestibuloplasty does not require stitches there is less discomfort and quicker healing.