Clinical aspects of the use of a vascularized mucoperiosteal palatine flap for the reconstruction of soft tissue defects

Abstract

Dental implantation, as a high-tech innovative direction in modern dentistry, can significantly increase the effectiveness of complex rehabilitation of patients with partial and complete loss of teeth. Methods for surgical treatment of patients with soft tissue deficiency in the area of dentition defects must meet the following requirements: minimally invasive; biological feasibility; predictability; the validity of the patterns of changes in the state of soft tissue structures of the maxillofacial during surgical intervention; the need to restore the morphological and functional components of the donor and recipient beds; the most careful attitude to the bone and soft tissue components of the alveolar crest of the jaws for subsequent dental implantation. The article presents the results of a multi-stage method for restoring soft tissue deficiency in 29 patients aged 37 to 60 years with terminal and included defects in the alveolar part of the lower jaw in the distal region using the developed surgical method for eliminating soft tissue deficiency with a vascularized muco-periosteal flap modeled in the projection of the hard palate. The effectiveness of the developed surgical technique is confirmed by clinical data characterizing the intensity of the postoperative inflammatory process, taking into account the developed criteria indicators, as well as morphological indicators of soft tissues in the projection of the apex of the alveolar part of the lower jaw in the area of dentition defects before and 3, 6, 9, 12 months after surgery. It was established that on the 30th day from the moment of surgical manipulations, the intensity of clinical manifestations of the postoperative inflammatory process in the studied patients was completely absent, and by the 12th month, the increase in the thickness of the soft tissue component in the region of the apex of the alveolar part of the lower jaw in the intervention area increased by 133.3%, at the same time, the value of soft tissue growth ranged from 2.2 mm to 3.7 mm. The analysis of the obtained results revealed the high efficiency of the developed method, allowing to expand the indications for dental implantation.