Laser vestibuloplasty in dentistry according to Edlan-Meicher, Clark, tunnel. The role of vestibuloplasty in dentistry Vestibuloplasty using a diode laser

Like any operation, vestibuloplasty will require the patient to undergo rehabilitation. A speedy recovery and the absence of complications depend on carefully following the doctor’s instructions.

Ice in a bag is applied to the intervention area for 6 hours according to the schedule: 20 minutes cold therapy, 20 minutes break. In this way, swelling is reduced.
For the first three days, brushing your teeth is done with a soft-bristled toothbrush without toothpaste. If the outcome is successful and a fibrin film forms on the wound, from the fourth day cleaning is carried out as usual.
You will need to use a gentle diet with the exception of sour, spicy, and salty foods. The temperature of the dishes is set to optimal, within 40-53 degrees.

In addition, for better healing and development of the operated area, patients are prescribed therapeutic exercises. The exercises are simple and effective. Required:

Perform an external two-minute light massage with your fingertips (five times a day);
Pout your lip for two minutes (five times a day);
Touch the tip of the tongue to the outer border of the created oral vestibule.

Possible complications after vestibuloplasty

The occurrence of undesirable reactions is usually calculated by the doctor, as well as a set of measures is thought out to mitigate side effects. Following the doctor's recommendations minimizes the risk of complications.

Most often, patients are concerned about increasing tissue swelling. The concern is due to the fact that the swelling becomes most pronounced on the third day after surgery. In fact, this is considered a physiological norm.

Sometimes the patient is embarrassed by the feeling of a foreign object in the mouth behind the lip, visible changes in the oval of the face. The listed symptoms are temporary and go away on their own.

Situations requiring medical intervention include fistulas, scars, and bleeding. Similar consequences can accompany any operation, not just vestibuloplasty.

A pathological decrease in sensitivity means that the nerve endings have been affected. The complication can be eliminated. Regeneration of nervous tissue occurs within a period of up to 9 months. Auxiliary physiotherapy procedures and a gymnastic complex are prescribed.

Effectiveness of the use of medical technology

Vestibuloplasty is not an operation performed at the request of the patient. It is carried out for medical reasons and is accompanied by statistical analysis showing the high effectiveness of the intervention used.

As a result of frenulum surgery, the depth of periodontal pockets decreases, and recession (thinning and compression) of the gums tends to zero.

In patients who have undergone vestibuloplasty before prosthetics with removable dentures, the devices are fixed to the jaw with maximum comfort.

According to reviews from those operated on, the installation is ideal; the use of adhesive bases is not required.

In adults, the exposed dental necks were tightened with a fabric roller, and the gum level stabilized.

In young patients, the bite changed and speech therapy difficulties were eliminated. In general, not only anatomical, but also psychological problems associated with the poor aesthetics of the appearance of the lips and the presence of a gummy smile (when the gums are exposed when smiling, and teeth are not visible) were eliminated.

Vestibuloplasty and frenuloplasty play a significant role in eliminating periodontal pathologies.

New technologies in the field of dentistry have made it possible to use the vestibuloplasty method in plastic surgery.

Effective surgery for anomalies of the lower jaw allows you to eliminate any defects in the vestibule of the oral cavity.

Vestibuloplasty is a surgical operation that is performed for the purpose of corrective manipulations in the anterior part of the oral cavity, limited externally by the cheeks and lips, and internally by the alveolar processes of the jaws and dental units.

If we consider the characteristics of the operation, then it can be classified as an intervention aimed at plastically eliminating deformations and defects of organs and tissues, however, its purpose is to get rid of dental problems.

The method allows you to reduce gum tension through surgical dysplasia of the muscular tissues of the oral cavity. Also, when carrying out the technique, the area of gingival tissue and the deepening of the entire area of the anterior part of the oral cavity (vestibule) increases.

Reasons for carrying out

The technique is used on both the upper and lower jaws, if indicated:

chronic periodontal diseases;
partial change in the mucous membrane before correction of malocclusions and jaw defects or implantation of a structure;
violation of distinct pronunciation;
decrease in the height of the gum volume in the area of the tooth neck (recession);
malocclusion;
changes in dental osseous tissue;
exposure of the tooth root;
if the gum tissue is high adjacent to the tooth.

Contraindications

The operation is permitted in the absence of the following diseases and pathologies:

cerebral vasculitis;
poor blood clotting caused by heredity;
oncological pathological processes in the oral cavity and beyond;
recovery period after radiation therapy for malignant tumors;
pronounced disturbances in the surface relief of the soft tissues of the oral cavity with the formation of dense scars;
purulent infection accompanied by an inflammatory process that spreads to all structures of the jaw system (osteomyelitis);
psychoneurological disorders;
addiction to alcohol, drugs, nicotine.

Preparation principle

Based on the fact that vestibuloplasty is performed using surgical methods, that is, direct intervention in the soft tissue structure, a thorough diagnosis must be carried out before its use.

To establish an accurate diagnosis and detect possible limitations in the use of the technique, specialists resort to standard studies:

visual exploration of the area;
thorough examination using instruments;
X-ray diagnostics.

In addition to preparatory manipulations by a specialist, the patient must adhere to special recommendations.

Its actions are as follows:

5-7 hours before surgery, do not eat solid foods that can damage the gum tissue.
Avoid taking painkillers, as this may affect the effect of local anesthesia.

The dentist must thoroughly clean the dentition from amorphous deposits, plaque and stones.

Types of operations

When performing plastic surgery, doctors use several modifications.

Edlan-Meihar method

The method is used quite often and has proven itself on the positive side. After the operation, permanent changes are observed.

However, the technique has a significant drawback, which is expressed in the exposure of part of the lip. The procedure is performed in several stages:

temporary decrease in pain sensitivity;
surgical dissection of the inner lining of the oral cavity along the bend line of the bone arch;
detachment of the inner membrane from the edge of the incision to the jaw;
formation of the vestibule of the oral cavity with subsequent fixation of the inner membrane;
applying a soft gauze bandage with a sterile agent to the wound area.

The recovery period lasts about 2 weeks.

In the video you can watch the process of vestibuloplasty using the Edlan-Meihar method.

Schmidt modification

The Schmidt method has some differences from the previous method. During this operation, the connective tissue surrounding the bone from the outside (periosteum, periosteum) is not peeled off.

The procedure is performed in the following order:

local anesthesia;
cutting off a tight cord in the muscle along the periosteum;
insertion of a tissue flap into the recess of the new corrected anterior part of the mouth;
fixation of the tissue flap with sutures.

Vestibuloplasty according to Clark

This type of plastic surgery is considered the simplest and most convenient. During surgery, the specialist makes an incision on the inside at the junction of the gum tissue with the moving parts of the mucous membrane of the anterior oral cavity, without affecting the periosteum.

The dissection is performed within the tissues of the anterior oral cavity to the periosteum and in the direction with the bone arch along the entire incision with a depth of 1.5 cm.

The edge of the inner membrane is inserted into the recess of the newly formed anterior part of the oral cavity and sewn to the periosteum using special threads. A bandage with iodoform is applied to the wound area.

Vestibuloplasty according to Glickman

This method is used for small anterior parts of the oral cavity, both over a large area and in a separate pathological area.

The procedure involves making an incision where the labial commissure meets the gum tissue. Next, soft tissue is peeled off without the use of sharp instruments near the periosteum to a depth of 1.5 cm in the area of the dentition.

The cords are intersected with scissors, and the tissue flap is sutured to the inner shell in the recess of the newly formed anterior part of the oral cavity to the connective tissue surrounding the bone tissue on the outside.

The open wound area heals with repeated tension under a protective bandage.

Tunnel method

This method has several positive aspects. Firstly, it is ideal for eliminating defects on both jaws, and secondly, it is a gentle correction option.

During the operation, the surgeon makes 3 incisions. The first one is performed parallel to the strand of the mucous membrane, and the next two are performed horizontally towards the small molars.

When using this method, the wound area is small, which speeds up healing. As a rule, after 10 days the soft tissues are completely restored.

For the procedure for performing the operation using the tunnel method, see the video.

Using laser

This innovation in plastic surgery is gaining momentum in the field of dentistry. The technique allows the operation to be performed without the use of a scalpel, which almost completely eliminates injuries.

The procedure involves the use of a laser beam, which gives it the following advantages:

the possibility of qualitative expansion of the anterior part of the oral cavity;
the permissibility of increasing the area of fixed gum tissue;
exclusion of swelling of soft tissues;
all cuts are made with extreme precision;
bleeding is excluded;
the risk of infection is reduced;
aesthetics are maintained at the highest level.

The rehabilitation period when using this technique is much shorter than that of other modifications.

Rehabilitation period

In the first three days after surgery, hygienic cleaning of the oral cavity should be done with a brush with soft bristles, without using toothpaste. Baths based on antiseptic agents are recommended.

Only on the fourth or fifth day of the recovery period is it possible to fully perform the procedure of cleaning the oral cavity and dentition.

In order for the results of vestibuloplasty to be positive, it is recommended to adhere to special rules for eating. Over the course of 14 days, the patient must:

do not drink alcoholic beverages;
do not eat hot, spicy, salty foods;
exclude dairy and fermented milk products (they can form hard plaque on teeth, which can cause infection of the wound area);
It is advisable to grind food or turn it into a creamy mass.

After each meal, the oral cavity is thoroughly rinsed with clean water and treated with an antiseptic.

In addition to proper nutrition, the patient is prescribed facial gymnastic exercises and massage:

external fingertip massage;
increased attempts to pout lips without including other facial muscles in the exercise;
moving the tip of the tongue in different directions in the area of the wound site.

Gymnastic training is performed for 3 minutes with each exercise repeated up to 6 times.

An interesting fact was noticed by patients. If you perform intensive exposure to a powerful stream of water from the outside, healing of the wound area occurs much faster, and discomfort during the recovery period is reduced.

During the rehabilitation period, patients should not burden the body with physical activity.

To monitor the stages of healing, the dentist prescribes the required number of appointments in order to promptly detect inflammation and prescribe appropriate and competent therapy.

Possible complications

Possible complications include:

Bleeding gums. In this case, special compresses are used and hemostatic agents are prescribed.
Decreased sensitivity of formations at the ends of nerve fiber processes. Happens when nerve endings are touched during a cut with a scalpel. As a rule, the injury goes away on its own within six months. In order to restore sensitivity as quickly as possible, doctors recommend resorting to exercises for the muscles of the maxillofacial area and physical therapy.
Keloid scar formation. The formation depends on the quality of the vestibuloplasty technique. The problem is eliminated by repeated surgery to remove scar tissue.
A fistula forms at the junction of the mucous membrane of the cheek and the gum. The pathology occurs in the area where the surgical suture is applied and is eliminated after the thread is removed.
Swelling of soft tissues. This complication always accompanies surgical interventions and disappears on its own after complete healing of the wound area.

Prices

The cost of surgery will directly depend on the method of its implementation:

Elan-Meicher method - 4000 rubles;
Schmidt modification using a scalpel - 3,500 rubles.
According to Clark - 4500 rubles.
According to Glikman - 4000-5000 rubles.
Tunnel method - 4800 rubles.
Using a laser - up to 10,000 rubles.

The cost of the service may vary individually depending on the complexity of the case and concomitant pathologies.

Contents [Show]

To improve the effect of orthodontic treatment in dentistry, it is sometimes necessary to resort to surgery. Depending on the indications, a certain type of operation is selected. One of the most common is the method of vestibuloplasty - an operation performed in the area of the vestibule of the oral cavity, that is, the space between the lips and teeth. Today we will tell you what this operation is, we will understand its types and indications for performance.

Indications for surgery

The operation is performed on both the lower and upper jaw. It is needed to deepen and expand the vestibule of the mouth, since insufficient area of this area can provoke various disorders and diseases. Surgical correction is performed in the following cases:

chronic periodontal diseases;
speech therapy problems caused by a small vestibule of the mouth;
preparation for orthopedic treatment to increase its effectiveness;
when implanting dental implants;
to prevent gum recession;
before performing patchwork operations;
to eliminate cosmetic defects.

These are the most common indications, but the doctor may decide to perform vestibuloplasty in some other cases.

There are several correction methods using vestibuloplasty. Each of them has its own advantages, disadvantages and features. Let's take a quick look at them.

Vestibuloplasty according to Clark. This method is used primarily for correction of the upper jaw, is carried out over a large area and is relatively simple. Without affecting the periosteum, the area between the mobile area of the mucosa and the gums is dissected. After detachment of the lip mucosa by 1 cm, the muscles and tendons move along the periosteum deeper in the lateral and frontal sections. Single muscle fibers may be removed. At the end of the operation, the mucosal flap is sutured to the periosteum with catgut, and the alveolar process is covered with a special film while the wounds heal.
Vestibuloplasty according to Edlan Meicher. This technique gives the most lasting results, therefore it is practiced most often. Meicher oral surgery is usually used to correct the lower jaw. The dissection is carried out as in the first case, but a deeper displacement of the submucosal tissues - muscles and tendons - is used. The fibers remaining on the wound tissue are removed, the mucous membrane is fixed in the new vestibule of the mouth and a protective bandage is applied for two weeks.
Tunnel surgery. The technique is universal, but vestibuloplasty of the lower jaw is more often done. It differs from the previous two options in that it is minimally traumatic. During its implementation, only three small incisions are made - two horizontally to the premolars, the third along the frenulum. Thanks to the gentle technique, the wounds heal completely within no later than 2 weeks.
Glickman method. This is a universal technique that can be applied locally or immediately to a large area of the lower or upper jaw. At the site of attachment of the lip, a dissection is performed, soft tissue is detached to a depth of about 1.5 centimeters, and the free edge is sutured to the resulting depression.
Schmidt's technique. It is performed on the upper or lower jaw without detachment of the periosteum tissue. The operation is characterized by cutting off the cords with muscles in a direction parallel to the periosteum. As a result, a flap is formed, the free edges of which are immersed into the depth of the new vestibule and fixed with sutures.
Laser vestibuloplasty is possible using any of the methods described above. Its only difference is the use of a laser instead of a scalpel. This method has many advantages. Complications are practically eliminated, high accuracy of cuts and invisible scars are achieved, there is no bleeding, and healing proceeds very quickly. Naturally, the price of the procedure will be higher, but the pain and rehabilitation period will be reduced.

The operation can be performed by any of these methods at the discretion of the attending physician, depending on the indications and clinical picture of the individual patient.

This is a simple operation that is performed quite often, but, as with any other surgical intervention, certain rules must be followed after it is performed.

Follow a gentle regimen.
Avoid increased physical activity for two weeks.
For the same period, stop eating any irritating food.
Regularly carry out thorough antiseptic treatment of the operated area.
Perform applications with wound healing agents.

Complications occur extremely rarely and in most cases are associated with violation of the recommended regimen. Most often, purulent-inflammatory processes develop, but they do not exceed 0.1% of the total number of operations performed.

In some cases, the operation may be refused, as there are a number of contraindications:

multiple dental caries;
cerebral damage;
malignant tumors;
bleeding disorders and other blood diseases;
osteomyelitis;
radiation irradiation of the neck and head;
collagenoses;
relapses of oral diseases.

It is important to understand that this is an ordinary dental operation that carries a minimal risk of complications, so you should not refuse it if you have indications for it. We invite you to watch the final video, which demonstrates plastic surgery using a laser. This video will convince you that there is nothing critically scary about vestibuloplasty.

In some cases, dental patients require lower jaw vestibuloplasty. We will describe what it is, indications, photos, reviews further. After all, people are often faced with similar procedures and are afraid to agree to them, because the unknown is scary.

The operation itself is performed in order to prevent various diseases in the oral cavity. By nature, not everyone has enough space between the teeth and the lip. Sometimes the tension in these muscles is too strong and needs to be removed for comfort.

The procedure itself is an increase in the space in the recess of the oral cavity between the teeth and lip. Due to various manipulations, which depend on the chosen correction method, the muscle fibers responsible for gum tension are displaced.

The operation is sometimes performed on the upper jaw, but most often vestibuloplasty concerns the lower row.

This procedure can be carried out for a variety of reasons. Sometimes this is a prevention of some diseases, and sometimes it is also for the treatment of existing ones. Vestibuloplasty is also used in prosthetics and pediatric dentistry.

The most popular indications for its implementation are:

to prevent periodontal inflammation and gingivitis;
for violations of the nutrition of the bone jaw;
to solve speech therapy problems;
for the purpose of exposing the roots of teeth in some cases;
in the process of preparing extensive orthodontic treatment;
when installing implants or removable dentures for their more convenient and reliable fastening;
Sometimes correction of cosmetic defects is also necessary.

Whether or not such a procedure is worth doing is up to the doctor, who can take into account all the indications, the patient’s health characteristics, the condition of the oral cavity and other factors.

Types of surgery

Let us briefly describe the most popular surgical techniques that are used today in dentistry to solve this problem:

According to Clark, this is the simplest method, but most often it is used for the upper jaw. The doctor cuts the mucous membrane between the teeth and the lip and peels it off a little. Thus, the desired muscles are moved deeper, and the dentist can remove some single fibers manually. Then the flap is sewn to the periosteum, and the wound itself is covered with a special protective film.
According to Edlan-Meicher - used for correction of the lower jaw. It is believed that this method gives lasting and good results. An incision is made along the bone in an arc, and part of the mucous membrane is peeled off towards the jaw. Some tissues are moved deeper or to the sides, and excess tissues are removed. Then the muscles are fixed with sutures and a bandage is applied.
According to Schmidt, this is a simpler method in which the periosteal tissue is not touched. Only an incision is made parallel to the bone and the edge of the flap is pulled inward and fixed.
According to Glickman, it can be used in both small and larger areas. The incision itself is made, in this case, exactly at the junction of the lip. The detached flap is sutured to the vestibule of the cavity.
Tunnel vestibuloplasty is used equally for the correction of the upper and lower jaws. It is believed that such an operation is less traumatic and the wound heals much faster. The cuts are made in three places, instead of one large one. This method is best suited for treating children.
Laser surgery is performed using a laser, which reduces the pain and trauma of the procedure. In this case, they do everything the same as in the usual procedure with a scalpel. But due to the use of a more technologically advanced tool, the entire process occurs accurately, purposefully, with less pain for the patient himself, and the wound subsequently heals faster. Another advantage of this procedure is the additional bactericidal effect in the surgical area.

The laser method is often used to remove the frenulum as an alternative to the conventional procedure. This helps reduce the child's fear, pain at the incision site and significantly speeds up healing.

Whatever method is chosen, it must be carried out by a qualified, experienced doctor and be sure to use some kind of anesthesia. Depending on the sensitivity of the patient, his health characteristics and age, local or general anesthesia is used. In addition to pain relief through injections, they can also use other methods.

In order for the entire process to be successful and with the least negative consequences, the patient must take responsibility for proper preparation for the operation. You should adhere to the following recommendations:

A person's success and confidence largely depends on how good he looks. The overall image includes a beautiful smile, a neat, well-groomed appearance, and pleasant speech.

But not everyone can boast of a pleasant appearance, straight and white teeth. In these cases, many resort to dental services to change their appearance.

In modern medicine, there are many methods that allow you to change the internal and external contours of the mouth. Among them, a type of surgical intervention stands out: vestibuloplasty, which is the correction of the oral cavity through surgery.

This method is classified as a plastic type of surgical intervention. This method is used in cases where a person has a small vestibule of the mouth and for some other indications.

By using vestibuloplasty, the tension on the gums is reduced as a result of the intraoral muscles moving.

Vestibuloplasty is most often performed on the lower jaw. This intervention is used if it is necessary to deepen and (or) widen the vestibule of the mouth, when its small area can lead to various kinds of disorders and pathologies.

Indications for use are:

prevention of gum recession;
chronic periodontitis;
in order to increase efficiency in preparation for orthopedic treatment;
implantation of dentures;
speech therapy disorders;
in order to eliminate cosmetic defects.

The listed indications are considered the most common. However, according to the decision of a specialist, vestibuloplasty can be performed in some other situations.

The operation is unacceptable in the following cases:

The patient is diagnosed with osteomyelitis;
there is extensive dental caries;
the head or neck area has been irradiated;
in case of relapse of any oral disease;
with existing blood pathologies and cerebral damage;
if malignant neoplasms are diagnosed.

If at least one of the above points is present, the body must be prepared in advance for surgery.

For example, if the teeth have a pathological condition, they need to be cured; after radiation therapy, it is important to restore the body, and the like. If this is not possible, the specialist will offer an alternative solution.

Vestibuloplasty according to Clark is one of the easiest. It is carried out on a large area in front of the mouth. It is also worth noting that this method is often used to correct the upper jaw.

Progress of the intervention:

First of all, the patient is given anesthesia;
cut the space between the mobile mucosa and the gum;
using scissors, the mucous membrane of the lips is peeled off;
tendons and muscles are moved deeper;
single muscle fibers are removed;
Once completed, the mucosal flap is sutured to the periosteum.

Vestibuloplasty according to Edlan Meicher is considered more popular because it gives better results. But, despite this, it also has some disadvantages, the main one of which is the exposure of the inside of the lip.

This type of intervention is used when correction of the lower jaw is necessary. All the same manipulations are carried out as in Clark’s method.

The peculiarity of this method is its versatility. Its use is possible not only over a large area, but also locally. The cut is at the attachment point of the lip. After this, the soft tissue is peeled off. The new free edge is hemmed to the place where the recess was made.

This type of surgery differs from previous ones. During its implementation, there is no detachment of the periosteal tissue. Muscle cutting is carried out parallel to its direction. The free edges of the new flap are advanced inward and fixed with sutures.

This option of vestibuloplasty is used to correct the lower or upper jaw. This method is the least traumatic compared to the others.

Incisions are made along the frenulum and in a horizontal direction to the premolars. Thanks to this, wound defects are significantly reduced, which promotes faster healing already on the tenth day.

Refers to innovative methods. The laser acts as a scalpel. It should be taken into account that such a correction is even less traumatic.

There is a great opportunity to increase the area and expand the vestibule.

Vestibuloplasty, which is performed with a laser, has a number of advantages:

slight swelling or its complete absence;
precise cut;
no bleeding;
reducing the number of pathogenic microorganisms;
decreased microcirculation of vessel walls;
fast recovery;
minimum scarring.

Whatever correction method is used, it is important to remember that a gentle regime is necessary for recovery.

During the first two weeks after surgery, it is important to avoid excessive physical activity. In addition, it is recommended to exclude any irritating foods from the diet:

spicy;
salty;
roast;
solid products.

For subsequent maintenance treatment, the doctor prescribes antiseptic drugs. Their use is necessary for wound treatment, which should be carried out daily.

massage with fingers, which is performed externally;
touching the tip of the tongue to the vestibule of the oral cavity;
pouting your lips for two minutes, this exercise is done up to five times a day.

The development of any serious consequences after this intervention is extremely rare. As a rule, they can only be provoked by non-compliance with the prescribed postoperative regimen. In some situations, purulent inflammation may occur. But these are only isolated cases, the percentage of which is less than 0.1 of the total number of operations.

Sometimes bleeding may occur or sensitivity may change at the site of the incision. You should not be afraid of this, since such phenomena pass after some time.

Reviews from patients who underwent vestibuloplasty in one way or another.

I had a Clark correction just a week ago. No stitches were required after the procedure. They just attached an overlay to the place where the cut was. A few hours later it resolved on its own.

To compress the incision, they also glued a plaster to the chin. At the moment, healing is proceeding without any complications, I don’t feel any particular pain. Only when smiling does discomfort and unpleasant sensations arise. I hope that this operation will help me get rid of periodontitis and bleeding gums.

Elena, Krasnodar

The need for this operation arose after a terrible car accident. Quite a lot of unpleasant hours and days were experienced.

I have already lost all hope for a beautiful smile and straight teeth. However, at the moment, five months after the operation, everything is fine with me. And this is only thanks to the experienced specialists who performed the vestibuloplasty operation with such a strange name - according to Kazanyan.

Maria, Moscow

More than a year and a half has passed since the day I had the correction. It is worth noting that the rehabilitation lasted quite a long time. It took a lot of time and effort for complete healing and adaptation.

I felt severe pain only in the first three days after the operation; after that, it only occurred periodically, and this only happened while talking and eating. At first it felt like my cheeks were just hanging down.

But, as they later explained to me, these were only the consequences of residual swelling, which went away after a few days. After this, a scar formed in the incision area. Quite an unpleasant phenomenon, I want to say, but he later disappeared. All this lasted about a year.

Restoration of sensitivity also did not occur immediately. For a long time, it seemed like I couldn’t feel my chin, it was just numb. I would like to note that, despite the long recovery in my case, it was worth it, the roots of my teeth are no longer exposed.

Natalya, Dnepropetrovsk

The price of vestibuloplasty will depend on the method used. The price threshold varies around three to six thousand rubles. The laser method of performing the operation costs 7-10 thousand rubles.

Vestibuloplasty - what is it? This question is asked by every patient who is prescribed such an intervention. There are several varieties of this procedure, as well as certain indications for which it is prescribed. The method by which correction is carried out depends on the specific situation.

Vestibuloplasty is a type of oral correction performed in the space between the lip and teeth. Dentists prescribe this operation when the vestibule of the patient’s mouth is too small. The need for correction is due to the fact that this situation can cause the development of a number of dental problems. The main indications for mandatory intervention are the following situations:

the patient has been diagnosed with periodontal disease, in particular periodontal disease or its complication in the form of periodontitis;
preparation for prosthetics to ensure high-quality fixation of the prosthesis;
implantation of an implant, especially with a very high attachment of the muscle to the alveolar process;
treatment by an orthodontist due to, for example, malocclusion;
according to the testimony of a speech therapist;
in order to prevent gum recession.

This procedure helps:

reducing gum tension;
deepening of the vestibule of the mouth;
expansion of the area of attached gum;
prevention of speech therapy, orthodontic and dental diseases.

However, there are also contraindications. The operation cannot be performed in the following situations:

multiple caries;
previous radiation therapy to the neck or head;
dental diseases in the relapse stage;
cerebral lesions;
oncology;
blood diseases.

In such cases, it is necessary to prepare the body for vestibuloplasty (for example, completely cure teeth, recover from radiation therapy). If this is not possible, you will have to look for alternative measures with your doctor.

A variety of dental problems can arise when there is excessive tension in the tissues of the mucous membrane in the vestibule of the oral cavity. The vestibule of the oral cavity is a space, on one side of which there is the inner surface of the cheeks and lips, and on the other, the outer surface of the gums and dentition.

If there is a need to adjust the vestibule of the oral cavity, vestibuloplasty is performed. This surgical intervention belongs to the category of plastic surgery of the oral cavity.

Prices for vestibuloplasty

Vestibuloplasty 19578 P

Vestibuloplasty specialists

Vaitsner Elena Yurievna

periodontist surgeon Candidate of Medical Sciences

2006 - Graduated with honors from the Moscow State Medical and Dental University. Evdokimova

2006-2007 - Internship at the Department of General Dentistry and Anesthesiology of Moscow State Medical University

2007-2009 - Clinical residency at the Department of Hospital Therapeutic Dentistry, Periodontology and Geriatric Dentistry of Moscow State Medical University

This type of surgery in adults is performed under local anesthesia, while vestibuloplasty in children is performed using intravenous or inhalation anesthesia.

Indications for vestibuloplasty

All indications for performing this operation can be divided into orthodontic, speech therapy and cosmetic.

Orthodontic indications include:

prevention of gum recession;
prevention of periodontal pathologies;
preparation for prosthetics so that dentures can be well secured;
preparation for dental implants;
preparation for flap operations aimed at covering exposed tooth roots.

Vestibuloplasty helps solve speech therapy problems such as:

difficulty phonating certain sounds
and imperfect speech.

Cosmetic indications include

shallow vestibule, which caused a cosmetic defect.

Video - vestibuloplasty

Contraindications

There are general and specific contraindications. General ones that prohibit any surgical interventions include:

myocardial infarction;
abnormal heart rhythm;
stroke;
various infectious and inflammatory diseases;
oncology;
blood diseases accompanied by high bleeding.

Particular contraindications:

multiple caries;
purulent diseases of the oral cavity;
osteomyelitis of the jaw bones.

Photo examples of vestibuloplasty

How vestibuloplasty is performed in our Center

The essence of this operation is to detach a certain area of the mucous membrane and secure it in the desired position. Taking into account the degree of complexity and location of the pathology, our dentist will select the optimal method for its implementation:

Vestibuloplasty according to Clark This is the most elementary technique for performing this manipulation. Most often, this type of vestibuloplasty is performed on the upper jaw, on a large area of the vestibule of the mouth.
Vestibuloplasty according to Edlan-Meicher This type of vestibuloplasty is performed on the lower jaw and gives the most long-lasting results. The disadvantage of this method is that the inside of the lip remains exposed.
Schmidt modification This method of mandibular vestibuloplasty is performed without detachment of periosteal tissue.
Vestibuloplasty according to Glickman This technique is used to correct areas of any size, and the incision is made at the attachment point of the lip.
Tunnel vestibuloplasty This method can be used on both jaws and involves making only three incisions that provide access to the submucosal tissue. It is advisable to do this kind of vestibuloplasty in children, since it is characterized by the lowest morbidity.

The specialists of our Center for Aesthetic Dentistry also perform laser vestibuloplasty. The surgical techniques remain the same, but the incisions are made not with a scalpel, but with a laser beam.

The main indicators of success and self-confidence are a beautiful smile, clear diction, contact behavior and an attractive aesthetic appearance.

Not all people can boast of a beautiful appearance, a seductive smile, charming facial expressions and straight teeth. Sometimes you have to seek the help of a dentist to help achieve fundamental changes in your appearance.

Modern medicine has great opportunities and innovative methods for shaping the external and internal contours of the mouth.

Not everyone is familiar with the term vestibuloplasty. This is a very delicate surgical intervention, the purpose of which is to eliminate pathology of the oral cavity.

This operation is performed in situations where the patient has a very small vestibule of the mouth. This deficiency can lead to serious dental problems.

What is the vestibule of the mouth? This small space is the gap that extends from the inner surface of the cheek and lip to the outer surface of the gums and teeth.

Normally, the depth of the vestibule is considered to be 4–5 mm in children aged 6–7 years, 6–8 mm at the age of 8–9 years, and by the age of 14–15 it should reach 10–14 mm. High attachment of the frenulum of the lower lip can cause local development.

Plastic and modern jaw surgery can solve many problems in the facial area.

If the patient has periodontal disease. In this case, surgical intervention will alleviate the patient’s condition and subsequently relieve these ailments.
Before starting the procedure to better secure the dentures.
In case of implantation of a dental implant. For example, if the muscle is attached to the alveolar process too high. In this case, if surgery is not performed, an inflammatory process will occur.
Before the start of the event.
If there are speech therapy problems.
Before an operation that will solve the problem with exposed tooth roots.
As a preventive measure against gum recession.

Types of this surgical intervention

There are several methods for performing this operation. Surgical intervention technologies are quite diverse.

According to Clark

This is an intervention for a minimally short period. The simplest method used for pathologies in the upper jaw.

Progress of the operation: First of all, anesthesia is given. The second step is when the surgeon cuts the mucous membrane between the gum line and the mobile area of the mucous membrane. The depth of the incision corresponds to the depth of the mucosa. Then, using scissors, the mucous membrane of the lips is peeled off. Muscles and tendons move deeper along the periosteum. Healing occurs in 2 – 3 weeks.

According to Edlan–Meicher

This technique is used to correct defects of the lower jaw. This method of intervention guarantees the greatest effect.

Progress of the operation: anesthesia is performed, the mucous membrane is cut, the mucous flap is peeled off and the submucosal tissue is moved deeper. The patch is fixed with sutures. A protective bandage is applied to the wound. The disadvantage of this method is the duration of healing.

Schmidt modification

The peculiarity of this method is the absence of detachment of periosteal tissue. The muscles are dissected parallel to the periosteum.

According to Glickman

This technique is used with equal success on all problem areas of the jaw. In this case, an incision is made in the area where the lip attaches.

Using a blunt instrument, the surgeon peels off the soft tissue, the free edge of which is sutured to the formed depression.

This operation is considered low-traumatic. The wound area is small, healing occurs within 10 – 11 days. This method is suitable for both jaws. It is also called tunnel vestibuloplasty.

Contraindications

In some cases, vestibuloplasty is contraindicated.

When a patient is diagnosed with multiple and complicated dental caries.
The patient has osteomyelitis.
In the presence of recurrent chronic diseases of the oral mucosa.
With cerebral damage.
If the patient has a tendency to form keloid scars.
For blood diseases such as hemophilia and leukemia.
After undergoing radiation therapy in the head or neck area.
In the presence of malignant tumors.

Use of laser in vestibuloplasty

During surgery, the laser plays the role of a scalpel.

This technique for expanding the vestibule of the mouth and increasing the area of fixed gums is the least traumatic of all the above.

Advantages of using laser:

With surgery this way, blood loss is minimized.
And another important advantage of this method is the complete absence of pathogenic bacteria and infections from entering the incision.
Using a laser, the surgeon can cut through tissue with high precision.
After such an operation, the patient practically does not form scars.
No swelling after surgery.
Patients experience a decrease in microcirculation of the vascular wall.
After surgery, using this method, a rapid process of restoration of damaged tissue occurs.

Each method has its own properties and characteristics. Based on these indicators, the doctor decides which option for a particular patient will be the most optimal.

After the operation, the doctor is obliged to give the patient recommendations regarding the management of the postoperative period, which will last 2–3 weeks.

In the video you can see how vestibuloplasty is performed using a laser:

To avoid complications, you must strictly follow all the dentist’s recommendations:

Regularly treat the wound with antiseptics.
Do not forget to use wound healing agents prescribed by your doctor.
Eliminate spicy, sour and salty foods from food; they greatly irritate the mucous membrane of the mouth.
Maintain oral hygiene.
During this period, it is necessary to minimize physical stress on the body.

If vestibuloplasty is performed at a high professional level and the patient adheres to the recommendations regarding the postoperative period, many dental problems can be avoided in the future.