Vestibuloplasty

The oral vestibule is the space between the lips or cheeks and the gums. When it is shallow, the lip pulls on the gum with every movement, food gets trapped at the tooth necks (the area next to the gum), a removable denture holds poorly and implants lack firm gum around them. Vestibuloplasty surgery deepens the vestibule and widens the zone of attached gum (firm, immobile gum around the teeth). At UKRMED it is performed in the surgical dentistry department.

Photo: Scientific Animations, Wikimedia Commons, CC BY-SA 4.0

What is vestibuloplasty

It is a surgical procedure in which the surgeon moves the attachment of the lip muscles and mucosa lower (in the lower jaw) or higher (in the upper jaw) to increase the depth of the vestibule. If needed, the area is covered with a graft (a piece of tissue from the palate or a collagen sheet) so that firm, immobile gum forms.

Who needs it

• a shallow vestibule with the lip pulling on the gum;
• gum recession (the gum moving down and exposing the root) progressing because of tissue tension;
• preparation for dental implants when there is too little firm gum around future implants;
• poor retention of a removable denture due to a shallow vestibule;
• combined with frenulum surgery if the frenulum attaches too close to the teeth.

The vestibuloplasty procedure

1. Examination and plan. The surgeon measures the vestibule depth, assesses the gums and bite and orders an X-ray if needed.
2. Preparation. If the gums are inflamed, periodontal treatment and cleaning come first.
3. Surgery under local anaesthesia: an incision in the mucosa, moving tissue to the required depth and, if needed, a graft.
4. Stitches and instructions. Stitches are removed after 1-2 weeks.

Studies compare vestibuloplasty with a free gingival graft (tissue from the palate) and with a collagen matrix (a ready-made collagen sheet, so no tissue is taken from you). The surgeon chooses the method based on the area, number of teeth and goal.

Recovery

• eat soft, not hot food for the first days;
• limit lip movement and do not pull the lip to look at the stitches;
• brush carefully around the area;
• take prescribed medicines and come for check-ups.

Prices

Sources

1. Schmitt C. M., Moest T., Lutz R. et al. Long-term outcomes after vestibuloplasty with a porcine collagen matrix (Mucograft) versus the free gingival graft: a comparative prospective clinical trial. Clin Oral Implants Res, 2016. https://doi.org/10.1111/clr.12575
2. Chambrone L., Sukekava F., Araújo M. G. et al. Root-coverage procedures for the treatment of localized recession-type defects: a Cochrane systematic review. J Periodontol, 2010. https://doi.org/10.1902/jop.2010.090540