[Soft tissue management of severe bone defect in the maxillary anterior area: a clinical guideline on the decision-making process].

• DOI: 10.3760/cma.j.cn112144-20250108-00006
• Publication Date: 2025-03-28
• Authors: M.-Z. Wang; Feng Liu; Jinou Chen; Wei Zhao
• Keywords: Guideline; Clinical Decision Making

Vertical bone augmentation (VBA) in the anterior maxilla is a technically and biologically challenging technique with high complication rates unpredictable outcomes. Selecting appropriate soft tissue management strategies crucial to avoid short-term long-term complications. This article aims assist clinicians making treatment decisions based on different conditions during VBA. It divided into two parts. Incision flap design quality quantity of tissues For mucosa good quantity, trapezoidal incision adopted, periosteum extension applied for tension reduction. shallow vestibular sulcus, larger used, reduction method mucosa-oralis muscle separation applied, along papilla transposition suture ensure primary wound closure. thin or perforating defects, pedicled periosteal used repair. Selection techniques second-stage surgery status improve esthetic horizontal free connective graft (CTG) palatal can be treatment; vertical such as iceberg customized CTG bowtie-like shape augmentation; combined platform three-dimensional reconstruction.