Vestibuloplasty refers to surgical modification of the oral cavity that might include enhancing the gingival-mucous membrane or bone density or extensive tissue rearrangement. The surgical procedures generally involve increasing the height and width of the gum region in preparation for dentures or oral implants. The extent of the surgery varies, depending on the amount of bone loss incurred and the size of the surface area requiring reconstruction. Surgery to repair the vestibular extension area extends anywhere from the outside of the teeth and gums to the inside of the cheeks.
Persons who wear dentures generally notice that, over time, the appliances becomes looser and looser, usually requiring relining of the denture plate or requiring the individual to undergo refitting for new dentures. Whether missing one tooth, the lower or upper teeth, or an entire mouthful of teeth, the gums and underlying bone typically deteriorate. After the loss of each tooth, the body reabsorbs the bone tissue causing shrinkage. The membranes and tissues covering the bone also diminish. Oral surgeons perform vestibuloplasty in an attempt to replace these losses.
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Oral surgeons usually perform vestibuloplasty in a hospital setting. The length of stay and subsequent recuperation time largely depend on the amount of repair necessary. In cases primarily involving tissue shrinkage, surgeons generally incorporate grafted tissue, provided by the patient, to build up and strengthen the ridge line for support of an implant or denture plate. Surgeons usually obtain the tissue by shaving an extremely thin slice of skin from the thigh, roof of the mouth or the eyelids.
When substantial bone loss occurs, physicians usually replace the bone with a bone graft or a synthetic device. Grafts for this procedure might involve taking bone from the patient’s own hip. In the event that very little bone or tissue remains that will adequately support any type of dental apparatus, surgeons may opt to perform extensive modifications.
In addition to merely increasing bone and gum height and width, surgeons might lower the floor or the roof of the mouth to gain more depth between the top of the gum and the sulcus, the cavity between the cheek and the gum. Oral surgeons also refer to this type of vestibuloplasty as sulcoplasty. During this surgery, physicians cut and lower the muscles and tissues that attach the cheek to the floor or roof of the mouth and the lips.
As with every surgical procedure, a variety of risks are involved. Excessive bleeding, swelling and infection might occur. Tissues might not heal properly. Nerve and muscle tissue might incur permanent damage resulting in facial drooping or sagging.