Journal of Oral Implantology – When a patient’s gums pull away from the space where there should be a tooth, surgeons often feel they need to attach tissue before placing a dental implant—a painful prospect for the patient. The cases presented in a recent study suggest there may be a better option, one that is fast, affordable, less painful and that ultimately improves the patient’s smile.
An article in the current issue of the Journal of Oral Implantology presents two cases in which a simple technique is used to add soft tissue around an implant as it is being placed. The inexpensive procedure takes only a few minutes and improves the look and feel of the implant, and possibly its long-term function.
Researchers do not yet agree on how much tissue is needed around an implant to keep the area healthy. However, it is clear that some tissue improves facial appearance and keeps food from becoming trapped in the space. Unfortunately, rebuilding the gums often requires a second, painful surgery that takes tissue from another part of the patient’s mouth and adds it to the implant space. Other methods can also cause the patient discomfort and increase the risk of disease even when they do not make the tissue in the gum area thicker.
Author William Liang presents two cases that show the vascularized buccal inversion flap (VBIF) technique, which doesn’t require a separate surgery, may be a better option. The VBIF neatly closes the soft tissue around the implant, making the shape of the gums look better as soon as the implant is placed. The author notes that the tidy closure means there is less chance of disease than with other methods used to attach gum tissue to an implant.
Still, because the exact position of the implant isn’t critical, Liang said that what really makes this technique unique is that it gives the surgeon flexibility. “‘The magic is in the magician, not the wand.’ The achievement of clinical excellence is ultimately in the clinician's hands,” he said. “Thoughtful and precise application of surgical techniques may provide a better clinical outcome regardless of the type of dental implant used.”
The article concludes that the numerous advantages of VBIF can improve the results of implant placement. James Rutkowski, the journal’s Editor-in-Chief, agrees: “Doing this relatively simple procedure will take only minutes and greatly improve the esthetic result.”
The full text of the article “Vascularized Buccal Inversion Flap,” Journal of Oral Implantology, Vol. 42, No. 5, 2016, is now available at https://joionline.org/doi/full/10.1563/aaid-joi-D-16-00043.
