Clinical application of the surgical navigation template construction for soft tissue transplantation to increase the width of the added keratinized gingiva

Abstract

BACKGROUND: In surgical periodontology, modifications of soft tissues help achieve a series of important tasks: increase the area of keratinized attached gums, increase the volume of soft tissues, and consequently improve the biological and esthetic state of soft tissues. To achieve these goals, the most common method is the extraction and transplantation of tissue grafts from the hard upper palate. To date, no design of a surgical navigation template allows taking a gingival graft by pre-programmed parameters. The article justifies the necessity of the development and clinical application of a navigational surgical template made with modern digital technologies and used in operations modifying the frontal oral cavity with the transplantation of free gingival grafts from the hard upper palate. AIM: To develop and apply in clinical practice a navigational surgical template for a programmable sampling of a free gingival graft for vestibuloplasty in patients with periodontal diseases. MATERIALS AND METHODS: With the use of modern digital technologies, the designs of individual surgical navigation templates for the intake and transplantation of free mucosal transplantation during vestibuloplasty were developed. The developed templates are used in clinical practice. RESULTS: For vestibuloplasty, navigational surgical templates for the extraction and transplantation of free gingival graft were developed and manufactured using modern digital technologies. As a result of this development, patents were obtained for the inventions Guiding template for soft tissue transplantation and Method of gum transplantation. The case study demonstrates the benefits of using the aforementioned navigational surgical templates. The invented method makes it possible to obtain donor tissues procured from an anatomically harmless portion of the hard upper palate. Moreover, the surgical templates make it possible to produce a recipient bed identical in shape and size to the removed donor transplant tissue, thereby making it possible to avoid the necessity of adapting the transplant in an artificial recipient bed outside the oral cavity and reducing the time spent by donor tissue detachment from any real oral cavity. CONCLUSIONS: Taking into account the positive results of the clinical testing of the proposed technology, a randomized study is warranted to evaluate the effectiveness of vestibuloplasty with a free gingival graft using a surgical navigation template in comparison with a similar operation performed using classical technology. It is necessary to identify the statistical significance of the obtained clinical results of treatment.