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FGG prior to Bone Graft & Implants in Posterior Mandible
Posted on 06.02.2019 04:44 AM
By Maurice Salama
In Soft Tissue Enhancement
A patient presents after failed implants desiring a solution. Knife edge ridge, no vestibule and No Keratinized Gingiva present. The plan is to first create a Vestibule and Thick KT to allow for BONE augmentation to be successful followed by implant placement. Here we create bed preparation, utilize autogenous palatal tissue and secure with monofilament sutures. Thoughts. Dr. Salama
Preop Ridge Condition
Bed preparation for Graft
Sutures of FGG
Sutures
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7 Comments
Maurice Salama says on 06.02.2019 04:45 AM
Comparison of result.....now onto Bone and Implants...
ABDUSALAM ALEMALI says on 06.02.2019 08:46 PM
Why he did FGG first
Is there any specific guideline ?
Regards
Maurice Salama says on 06.18.2019 03:39 PM
Abdusalam; See my responses below. regards Dr. Salama
andoni jones says on 06.03.2019 07:30 AM
Eternal dilemma here, to do it before or after. Would you not find there will be more scarring on the tissues making it more difficult to mobilize the flap when you are doing the graft? Regards Mo
Maurice Salama says on 06.18.2019 03:39 PM
Andoni; Once you get past the new KT and fibRous healed tissues you can release as well as the original flap. regards Maurice
Craig Misch says on 06.03.2019 10:24 PM
This is also my first choice for managing the atrophic mandible. You could wait and do soft tissue augmentation after implant placement but this improves the site for bone augmentation. Nice work!
Maurice Salama says on 06.18.2019 03:38 PM
Thanks Craig, I agree that my bone rafting works much better when I have dense KT, less muscle attachments to fight with and more vestibule length. Great to see you last week in Boston. regards Mo