Preprosthetic Laser Assisted Mandibular Vestibuloplasty

Download Article

1 / O. Dimitrovski2 / D. Popovic Monevska3

1Faculty of Dentistry, Department of Oral Surgery, Skopje, FYROM, Slavejko Arsov 30½ 1000 Skopje,Macedonia (the former Yugoslav Republic of)
2Faculty of Dentistry, Department of Oral Surgery, Skopje, FYROM,Macedonia (the former Yugoslav Republic of)
3Faculty of Dentistry Department of Maxillofacial Surgery Skopje, FYROM,Macedonia (the former Yugoslav Republic of)

Summary

A prosthetic treatment of the edentulous mandible can be very challenging. In cases with inadequate buccal depth, a necessary deepening of the oral vestibule can be achieved by surgically detaching the soft tissue attachments. A preprosthetic vestibuloplasty is usually done surgically by scalpel. With the permanent advancement of laser technology, a laser vestibuloplasty has become a preferred surgical procedure. The aim of this report was to present individuality of a mandible vestibuloplasty performed with Er.YAG laser.

A 69-year-old patient was referred to the University Department of oral surgery after several previous unsuccessful attempts to stabilize his lower denture. The intraoral assessment revealed complete mandibular edentulism and a shallow vestibule with sufficient bone height in the anterior region. Since the patient’s financial resources precluded dental implants, mandible anterior vestibuloplasty was planned to deepen the vestibule thus increasing the anatomic basis for prosthetic rehabilitation. The vestibuloplasty was performed with Er-Yag Laser (Fotona Fidelis III). The laser ablation started at the mucogingival junction. The soft tissue bands were ablated layer by layer till the desired vestibular depth was achieved. There was no need for suturing. No protective barrier was placed. The postoperative recovery was symptomless, without pain, oedema, or signs of infection. Four weeks after surgery, the healing process was completed and sufficient anterior vestibular depth was gained and maintained. Er.YAG laser assisted vestibuloplasty was a minimally invasive surgical procedure. The fast healing with minimal scarring resulted and a sufficient vestibular depth was gained.

Keywords: Mandibular Vestibuloplasty; Er.Yag Laser; Preprosthetic Surgery

References

  1. Yilmaz E, Ozcelik O, Comert M, Ozturan S, Seydaoglu G, Teughels W, et al. Laser-assisted laterally positioned flap operation: a randomized controlled clinical trial. Photomed Laser Surg, 2014; 32:67-74. [Web of Science]
  2. Hillerup S. Preprosthetic mandibular vestibuloplasty with split-skin graft: A two-year follow-up study. Int J Oral Maxillofacial Surg, 1987; 16:270-278.
  3. Hillerup S, Hjørting-Hansen E, Solow B. Influence mandibular vestibuloplasty. A 5-year clinical and radiological follow up study. Int J Oral Maxillofac Surg, 1990; 19:212-215.
  4. Hjørting-Hansen E, Adawy AM, Hillerup S. Mandibular vestibule-lingual sulcoplasty with free skin graft: A fiveyear clinical follow-up study. J Oral Maxillofac Surg, 1983; 41:173-176.
  5. Froshi T, Kercher A. The optimal vestibuloplasty in preprosthetic surgery of the mandible. J Craniomaxillofacial Surgery, 1997; 25:85-90.
  6. Devaki VN, Balu K, Ramesh SB, Arvind RJ, Venkatesan. Pre-prosthetic surgery: Mandible. Journal of Pharmacy & Bioallied Sciences, 2012; 4(Suppl 2):S414-S416.
  7. Venugopalan V. Pulsed laser ablation of tissue: surface vaporization or thermal explosion? SPIE Proc, 1995; 2391:184-189.
  8. Aoki A, Watanabe H, Ishikawa I. Er:YAG clinical experience in Japan: a review of scientific investigations. SPIE Proc, 1998; 3248:40-45.
  9. Niemz MH. Laser-Tissue Interactions: Fundamentals and Applications (Biological and Medical Physics). 2nd ed. Berlin, Germany: Springer-Verlag, 2002; pp 45-80.
  10. Walkinski C. Dental lasers: Possibilities and benefits. Journal of Massachussets Dental Society, 2004; 53(3):7-9.
  11. Ando Y, Aoki A, Watanabe H, et al. Bactericidal effect of Er:YAG laser on periodontopathic bacteria. Lasers Surg Med, 1996; 19:190-200.
  12. Clayman L, Kuo P, eds. Lasers in Maxillofacial Surgery and Dentistry. New York, NY: Thieme Medical Pub, 1997; pp 19-28.
  13. Kesler G, Koren R, Kesler A, et al. Periodontal plastic surgery: thermal effect analysis using Erbium:YAG Kesler’s handpiece. Histochemical evaluation by Picrosirius red stain and polarization microscopy for collagen determination. SPIE Proc, 2000; 3910:2
Citation Information: Balkan Journal of Dental Medicine. Volume 20, Issue 3, Pages 182–185, ISSN (Online) 2335-0245, DOI: https://doi.org/10.1515/bjdm-2016-0030, November 2016

COMMENTS