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Vestibuloplasty; anterior

CPT4 code

Name of the Procedure:

Vestibuloplasty; anterior
Common name(s): Anterior Vestibuloplasty

Summary

Vestibuloplasty is a surgical procedure to reshape and deepen the oral vestibule, which is the area between the gums, lips, and cheeks. The anterior approach focuses on the front part of the mouth. This procedure is often performed to prepare the mouth for dentures by creating more space and better tissue support.

Purpose

Vestibuloplasty addresses inadequate vestibular depth and soft tissue support, which can interfere with the fit and comfort of dentures. The procedure aims to provide a more stable and comfortable denture-wearing experience by enhancing the gum area.

Indications

  • Poor denture stability and retention
  • Shallow vestibule making it difficult to place and wear dentures
  • Patients with significant bone resorption in the jaw

Preparation

  • Fasting is typically required for a minimum of 6 hours before the procedure.
  • Medication adjustments may be needed, particularly blood thinners.
  • Pre-operative assessments including dental X-rays and physical examination of the oral cavity.

Procedure Description

  1. Anesthesia is administered (local or general, depending on the extent of the surgery and patient comfort).
  2. The surgeon makes an incision in the gum tissue of the anterior vestibule.
  3. Gum tissue is repositioned and secured in a way that deepens the vestibule.
  4. Excess or redundant tissue may be trimmed.
  5. Sutures are placed to hold the tissue in its new position and to promote healing.

Tools used:

  • Scalpel
  • Surgical scissors
  • Sutures
  • Retractors

Duration

The procedure typically takes about 1 to 2 hours.

Setting

Vestibuloplasty is usually performed in a hospital, outpatient clinic, or a specialized surgical center.

Personnel

  • Oral surgeon or dental surgeon
  • Surgical nurse
  • Anesthesiologist (if general anesthesia is used)

Risks and Complications

  • Infection
  • Bleeding
  • Swelling and bruising
  • Scarring
  • Numbness or altered sensation in the operated area

Benefits

  • Improved stability and comfort of dentures
  • Enhanced oral functionality
  • Increased patient confidence and quality of life

Benefits are typically noticed within a few weeks as the area heals and patients begin using their new or adjusted dentures.

Recovery

  • Patients will receive instructions on oral hygiene and wound care.
  • Pain management typically involves over-the-counter pain relievers or prescribed medication.
  • Soft diet is recommended for the first few days post-surgery.
  • Stitches are usually removed in about 1 to 2 weeks.
  • Full recovery generally takes around 4 to 6 weeks.
  • Follow-up appointments are necessary to monitor healing and denture fitting.

Alternatives

  • Soft tissue grafting
  • Bone augmentation
  • Use of denture adhesives

Each alternative has its pros and cons, such as varying degrees of invasiveness, cost, and effectiveness compared to vestibuloplasty.

Patient Experience

During the procedure, patients under local anesthesia may feel pressure but should not feel pain. Post-operatively, patients may experience pain, swelling, and minor bleeding. Pain can be managed with prescribed or over-the-counter medications. Comfort measures include rinsing with saline solution and maintaining a soft diet. Complete healing and comfort with new or adjusted dentures will develop gradually over the recovery period.

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