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Volume 29 , Issue 1
January/February 2014

Pages e10e12

Split-Thickness Flap with a Semicircular Punched-Ridge Pedicled Periosteal Flap for Implant Restoration in Highly Atrophic Patients: A Technical Note

Rudolf Seemann, PhD, MD, DMD, MSc, MBA/Christos Perisanidis, PhD, MD, DMD/Hannes Traxler, MD/Rolf Ewers, PhD, MD, DMD

PMID: 24451876
DOI: 10.11607/jomi.3059

Attached gingiva is a crucial aspect of healthy peri-implant tissue. Severely atrophied jaws have minimal quantities of attached gingiva. Any surgical procedure bears the potential risk of further loss of attached gingiva. The split-thickness flap described here provides excellent access. Using a biopsy punch, the periosteum is easily cut in semicircular fashion on the labial surface of the bone so that it remains pedicled on the lingual or palatal ridge. The split-thickness flap permits fixation of the gingival flap to the periosteum. The periosteal flap is closed with sutures to achieve soft tissue closure over the implants even in case of simultaneous vestibuloplasty.

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