Creating Attached gingiva in a full arch lower jaw
The lower jaw has one major problem. ATTACHED GINGIVA. The minute the teeth are removed the gingiva shrinks as a result we end up with very limited attached gingiva. When placing implants we often use Full thickness flaps and simply suture the flaps back into position around the abutments. As a result the attached gingiva shrinks even further leaving a situation that has potential dire consequences for the future. Lack of attached gingiva and muscle pull our contributors two periimplantitis.
Showing below is a very simple technique of vestibuloplasty prior to implant placement which allows the creation of a thick band of attached gingiva. an apically reposition flap is prepared split thickness and then sutured with periosteal sutures at an apical level. The initial incision is made in the attached gingiva thus only allowing keratinised epithelium to grow in.