Thermoplastic Vestibuloplasty: A Novel Technique for Treatment of Lip and Cheek Adhesion
Identifieur interne : 000019 ( Pmc/Curation ); précédent : 000018; suivant : 000020Thermoplastic Vestibuloplasty: A Novel Technique for Treatment of Lip and Cheek Adhesion
Auteurs : Khaled Barakat ; Aya AliSource :
- Craniomaxillofacial Trauma & Reconstruction [ 1943-3875 ] ; 2014.
Abstract
Lip and cheek adhesion to the opposing alveolus with complete or partial loss of the vestibular dimension represents a challenging problem for reconstruction. It usually occurs due to primary inadequate vestibular soft tissue repair following complicated trauma cases, burns, and lesions of the oral cavity. Surgical removal of scar tissue and creation of new vestibule is complicated by readhesion between the opposing connective tissue surfaces. Skin grafts and acellular dermal matrix represent the most dominant modalities used to treat deficient vestibule dimensions, but they are difficult to fix and lack the required stability during healing. Several devices have been created in an attempt to keep the tissues apart but their complex anchorage methods seriously reduced their reliability and usage. We devised a simple and reliable technique “thermoplastic vestibuloplasty” (TV) that benefit from the inherent reepithelialization capabilities of the oral mucosa to prevent readhesion and to resurface the created vestibule with its exact tissue color and texture. In total, 10 patients suffering from complete or partial lip or cheek adhesion with concomitant loss of vestibule were surgically treated by excising scar tissue and creating a new vestibule, followed by TV technique. Pre and posttreatment results were compared in terms of vestibular length, lip or cheek mobility, and change by time in vestibular length from 2 weeks up to 3 months. Moreover, the patient satisfaction and outcomes were measured using visual analogue scale score. All patients tolerated the procedure without complication. The mean vestibule length and mobility significantly increased from 3.8 + 0.6 mm to 11.4 + 1.4 mm (
Url:
DOI: 10.1055/s-0034-1375171
PubMed: 25383145
PubMed Central: 4221139
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<author><name sortKey="Ali, Aya" sort="Ali, Aya" uniqKey="Ali A" first="Aya" last="Ali">Aya Ali</name>
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<front><div type="abstract" xml:lang="en"><p>Lip and cheek adhesion to the opposing alveolus with complete or partial loss of the vestibular dimension represents a challenging problem for reconstruction. It usually occurs due to primary inadequate vestibular soft tissue repair following complicated trauma cases, burns, and lesions of the oral cavity. Surgical removal of scar tissue and creation of new vestibule is complicated by readhesion between the opposing connective tissue surfaces. Skin grafts and acellular dermal matrix represent the most dominant modalities used to treat deficient vestibule dimensions, but they are difficult to fix and lack the required stability during healing. Several devices have been created in an attempt to keep the tissues apart but their complex anchorage methods seriously reduced their reliability and usage. We devised a simple and reliable technique “thermoplastic vestibuloplasty” (TV) that benefit from the inherent reepithelialization capabilities of the oral mucosa to prevent readhesion and to resurface the created vestibule with its exact tissue color and texture. In total, 10 patients suffering from complete or partial lip or cheek adhesion with concomitant loss of vestibule were surgically treated by excising scar tissue and creating a new vestibule, followed by TV technique. Pre and posttreatment results were compared in terms of vestibular length, lip or cheek mobility, and change by time in vestibular length from 2 weeks up to 3 months. Moreover, the patient satisfaction and outcomes were measured using visual analogue scale score. All patients tolerated the procedure without complication. The mean vestibule length and mobility significantly increased from 3.8 + 0.6 mm to 11.4 + 1.4 mm (<italic>p</italic>
< 0.001) and from 0.3 to 2 (<italic>p</italic>
< 0.001), respectively. Regarding the stability of the achieved vestibular length it decreased by 14% when compared from 2 weeks to 3 months postoperatively. TV technique is a new simple and reliable technique that can effectively prevent readhesion of opposing connective tissue surfaces until intrinsic reepithelialization can resurface the newly created vestibular tissues forming a stable vestibular length with excellent color and texture.</p>
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<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Craniomaxillofac Trauma Reconstr</journal-id>
<journal-id journal-id-type="iso-abbrev">Craniomaxillofac Trauma Reconstr</journal-id>
<journal-id journal-id-type="doi">10.1055/s-00000151</journal-id>
<journal-title-group><journal-title>Craniomaxillofacial Trauma & Reconstruction</journal-title>
</journal-title-group>
<issn pub-type="ppub">1943-3875</issn>
<issn pub-type="epub">1943-3883</issn>
<publisher><publisher-name>Thieme Medical Publishers</publisher-name>
<publisher-loc>333 Seventh Avenue, New York, NY 10001, USA.</publisher-loc>
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<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
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<title-group><article-title>Thermoplastic Vestibuloplasty: A Novel Technique for Treatment of Lip and Cheek Adhesion</article-title>
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<contrib-group><contrib contrib-type="author"><name><surname>Barakat</surname>
<given-names>Khaled</given-names>
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<degrees>PhD, OMFS</degrees>
<xref rid="AF130290oa-1" ref-type="aff">1</xref>
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<contrib contrib-type="author"><name><surname>Ali</surname>
<given-names>Aya</given-names>
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<degrees>MSc</degrees>
<xref rid="AF130290oa-2" ref-type="aff">2</xref>
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<aff id="AF130290oa-1"><label>1</label>
<institution>Faculty of Dentistry, Oral and Maxillofacial Surgery, Minia University</institution>
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<aff id="AF130290oa-2"><label>2</label>
<institution>Department of Periodontology, Minia University, Cairo, Egypt</institution>
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<author-notes><corresp id="CO130290oa-1"><bold>Address for correspondence </bold>
Khaled Barakat, PhD, OMFS <institution>Faculty of Dentistry, Oral and Maxillofacial Surgery</institution>
<addr-line>Minia University, Cairo, Egypt 11361</addr-line>
<email>send2kbarakat@yahoo.com</email>
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<pub-date pub-type="epub"><day>21</day>
<month>5</month>
<year>2014</year>
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<pub-date pub-type="ppub"><month>12</month>
<year>2014</year>
</pub-date>
<volume>7</volume>
<issue>4</issue>
<fpage>258</fpage>
<lpage>262</lpage>
<history><date date-type="received"><day>22</day>
<month>9</month>
<year>2013</year>
</date>
<date date-type="accepted"><day>29</day>
<month>9</month>
<year>2013</year>
</date>
</history>
<permissions><copyright-statement>© Thieme Medical Publishers</copyright-statement>
</permissions>
<abstract><p>Lip and cheek adhesion to the opposing alveolus with complete or partial loss of the vestibular dimension represents a challenging problem for reconstruction. It usually occurs due to primary inadequate vestibular soft tissue repair following complicated trauma cases, burns, and lesions of the oral cavity. Surgical removal of scar tissue and creation of new vestibule is complicated by readhesion between the opposing connective tissue surfaces. Skin grafts and acellular dermal matrix represent the most dominant modalities used to treat deficient vestibule dimensions, but they are difficult to fix and lack the required stability during healing. Several devices have been created in an attempt to keep the tissues apart but their complex anchorage methods seriously reduced their reliability and usage. We devised a simple and reliable technique “thermoplastic vestibuloplasty” (TV) that benefit from the inherent reepithelialization capabilities of the oral mucosa to prevent readhesion and to resurface the created vestibule with its exact tissue color and texture. In total, 10 patients suffering from complete or partial lip or cheek adhesion with concomitant loss of vestibule were surgically treated by excising scar tissue and creating a new vestibule, followed by TV technique. Pre and posttreatment results were compared in terms of vestibular length, lip or cheek mobility, and change by time in vestibular length from 2 weeks up to 3 months. Moreover, the patient satisfaction and outcomes were measured using visual analogue scale score. All patients tolerated the procedure without complication. The mean vestibule length and mobility significantly increased from 3.8 + 0.6 mm to 11.4 + 1.4 mm (<italic>p</italic>
< 0.001) and from 0.3 to 2 (<italic>p</italic>
< 0.001), respectively. Regarding the stability of the achieved vestibular length it decreased by 14% when compared from 2 weeks to 3 months postoperatively. TV technique is a new simple and reliable technique that can effectively prevent readhesion of opposing connective tissue surfaces until intrinsic reepithelialization can resurface the newly created vestibular tissues forming a stable vestibular length with excellent color and texture.</p>
</abstract>
<kwd-group xml:lang="en"><title>Keywords</title>
<kwd>lip adhesion</kwd>
<kwd>cheek adhesion</kwd>
<kwd>vestibuloplasty</kwd>
<kwd>stent</kwd>
<kwd>oral mucosa</kwd>
<kwd>vestibule reconstruction</kwd>
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