Mucogingival surgery. The subperiosteal vestibule extension. Clinical results 2 years after surgery

Abstract

A surgical technique to establish wide zones of attached mucosa was performed in 28 patients presenting with inadequate amounts of attached gingiva. The clinical results of the procedure were monitored over a period of 2 yr. Biometric assessment of 112 mucogingival units immediately before and at 1, 3, 6, and 24 mo. after surgery revealed that the mean width of attached gingiva changed from 1.1-5.3 mm of attached tissue (gingiva plus vestibular mucosa). A surgically produced increase of 4.9 mm in width (P < 0.001) and subsequent shrinkage of 0.7 mm or 14% (P < 0.01) resulted in a total average gain of 4.2 mm of attached mucosa 2 yr after surgery (P < 0.001). A begin/end analysis of the coronal level of clinical periodontal attachment and the extent of gingival recession showed no clinically significant changes. The mean width of keratinized gingiva increased 0.8 mm during the 2 yr postoperative period. The subperiosteal vestibule extension is recommended as an alternative to the free autogenous mucosa graft for establishing wide bands of attached mucosa in areas where loss of attached gingiva is associated with mechanical or microbial irritation of the marginal periodontium.