What is vestibuloplasty?

Vestibuloplasty refers to surgical modification of the oral cavity that could include improvement of the gingival mucous membrane or bone density or extensive tissue rearrangement. 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 that requires reconstruction. Surgery to repair the buccal extension area extends from the outside of the teeth and gums to the inside of the cheeks.

People who wear dentures typically notice that, over time, the appliances become increasingly loose, usually requiring re-fitting of the denture plate or requiring the individual to be re-fitted for a new denture. Whether you have a missing tooth, upper or lower teeth, or a mouth full of teeth, the gums and underlying bone usually deteriorate. After the loss of each tooth, the body reabsorbs bone tissue causing shrinkage. The membranes and tissues that cover the bone also decrease. Oral surgeons perform vestibuloplasty in an attempt to replace these losses.

Oral surgeons usually perform vestibuloplasty in a hospital. The length of stay and subsequent recovery time depend largely on the amount of repair needed. In cases that primarily involve tissue contraction, surgeons typically incorporate grafted tissue, provided by the patient, to build and strengthen the ridge line for support of an implant or prosthetic plate. Surgeons usually harvest the tissue by shaving an extremely thin piece of skin from the thigh, roof of the mouth, or eyelids.

When substantial bone loss occurs, doctors usually replace the bone with a bone graft or synthetic device. Grafting for this procedure may involve removing bone from the patient's own hip. In the event that there is very little bone or tissue left that can adequately support any type of dental appliance, surgeons may choose to make extensive modifications.

In addition to simply increasing the height and width of the bones and gums, surgeons can lower the floor or roof of the mouth to gain more depth between the top of the gums and the sulcus, the cavity between the cheek and the gum. Oral surgeons also refer to this type of vestibuloplasty as a sulcoplasty. During this surgery, doctors cut and lower the muscles and tissues that attach the cheek to the floor or roof of the mouth and lips.

As with every surgical procedure, there are a variety of risks involved. Excessive bleeding, swelling, and infection may occur. The tissues may not heal properly. Nerve and muscle tissues can sustain permanent damage resulting in facial drooping or sagging.

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