Efficacy of the split-thickness labial flap method for soft tissue management in anterior ridge horizontal augmentation procedures: A clinical prospective study in the anterior maxilla

Objective: To introduce a novel method of split-thickness labial flap in maxillary anterior ridge horizontal augmentation and to evaluate its efficacy and morbidity. Materials and methods: 230 patients were selected to receive either particulate or onlay grafting. A split-thickness labial flap was applied to cover the grafted area and close the wound. The incidence of post-surgical complications and the level of patient discomfort were evaluated. A visual analog scale was used to quantify the amount of pain and swelling in the patients. Results: In all 375 surgical sites, passive primary closure was achieved with the split-thickness labial flap method. Membrane exposure after surgery was seen in 6 cases in the onlay group and in 4 in the particulate group. No long-lasting pain (> 1 week), paresthesia, or signs of infection occurred during the follow-up period of 6 months. The mean pain and swelling scores in the particulate graft group (2.75 +/- 3.01 and 2.02 +/- 2.51, respectively) were lower than the scores in the onlay graft group (3.18 +/- 2.79 and 3.85 +/- 2.25, respectively). Conclusions: The flap advancement technique presented in this study facilitates clinically passive primary closure. This technique can be used successfully in both particulate and onlay horizontal graft procedures. (C) 2017 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.