Vestibuloplasty study done by Axel Ergenholtz and Anders

Vestibuloplastyis a surgical procedure designed to deepened oral vestibule by changing softtissue attachments.

Various surgical modalities have been used forvestibuloplasty including sub mucosal vestibuloplasty, secondary epithelisationvestibuloplasty (Kazanjiantechnique, Edlan-Mejchar vestibuloplasty) andsoft tissue grafting vestibuloplasty. Edlan andMejchar technique was given by Edlan and B Mejchar (1963) and it is secondaryepithelisation vestibuloplasty. In secondary epithelisation the mucosa ofvestibule is used to line one side of the extended vestibule, and the otherside heals by growing new epithelial surface. Edlan and Mejchar technique is amodification of Kazanjian technique. Edlan andMejchar depicted a technique for vestibuloplasty which was applicable topatients in whom there were no pockets and little or no gingival tissue present.This procedure also increases the width of the attached gingiva where otherprocedures were impracticable due to lack of vestibular depth.2,3,4 Thistechnique is also indicated in treatment of localized recession or forelimination of a broad, high frenum. Edlan andMejchar technique known as lip switch procedure or transpositional flap orEdlan vestibuloplasty.

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The advantage of this technique no bone is left exposed,it minimizes the chances of bone resorption and recession. Another advantage ofthis technique is there are no relapses of the vestibule and scar formation isminimal. In the present case, an excellent clinical result was obtained whichwas maintained even 3 month after surgery.Several techniques have been developed since1956, but most of them are unsatisfactory due to scar formation and frequentrelapse of the state of the vestibule.  Compared to another widely usedperiosteal fenestration technique there is minimal contraction of thevestibular depth gained and minimal scar formation. 5This finding isconsistent with the observations of Wade (1969)6. A study done byAxel Ergenholtz and Anders Hugoson stated that net gain was of 7.

7 mm which wasfollowed upto 5 years. The condition was stabilized and maintained.3Problemassociated with shallow vestibule is improper maintenance of oral hygienebecause of traumatic brushing.

Various brushing techniques require theplacement of the toothbrush at the gingival margin, which may not be possiblewith reduced vestibular depth. It has been reported that with minimal of 1 mmof attached gingiva, proper gingival health cannot be established. CONCULSION: Based on the clinicalfindings of the present case it can be concluded that in cases with a shallow vestibuleand a reduced width of attached gingiva on the labial aspect of the mandibularanterior teeth, this technique provides a predictable way in which oral healthcan be achieved and maintained.

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