Ridge augmentation using modified-vascularized connective tissue graft: A case report

Objectives: Alveolar ridge defects resulting from tooth loss can lead to esthetical and functional problems in anterior maxillary area. Conventional soft tissue augmentation techniques may be inadequate when soft tissue is insufficient in this region. In this case report, we aimed to treat the alveolar ridge defect with vascularized connective tissue graft using modified soft tissue augmentation procedure. Methods: A 66 year old man with a Seibert class I alveolar ridge defect in right maxillary central incisor region was treated by vascularized connective tissue graft using modified soft tissue augmentation procedure. First, posh flap was reflected in recipient site. Extraction socket in the alveolar ridge defect region was filled with hydroxyapatite bone graft material. After modified vascularized connective tissue graft was placed, primary flap closure was obtained. Provisional restoration was placed. Direct soft tissue measurements were performed in vertical direction and horizontal measurements were performed by digital caliper. All soft tissue measurements were recorded at baseline, 1. and 2. months. Clinical periodontal measurements were recorded at baseline, 1., 2., 6. and 12. months . Results: Augmentation site was healed uneventfully. No differences were found in clinical periodontal parameters during the follow up period of case. Alveolar ridge defect was decreased in both vertical and horizontal direction. At baseline vertical soft tissue defect depth was 2.36 mm and increased at 1. and 2. months (4.7 and 4.6 respectively). Horizontal soft tissue width was increased at 1. and 2. months compare to the baseline. Conclusion: Modified vascularized connective tissue graft procedure may be useful in augmenting alveolar ridge defects. Provisional restoration is recommended for soft tissue remodeling of pontic site after the augmentation. Two months will be enough time for remodelation of soft tissue.