Technical Note on the Modified Submucosal Vestibuloplasty Around Dental Implants: A Case Report

Sung-Jo Lee; Dae-Young Kang; Hyeon-Seong Ahn; In-Woo Cho

doi:10.32542/implantology.2025024

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2025 Vol.29, Issue 4 Preview Page

Clinical or Case Report

Technical Note on the Modified Submucosal Vestibuloplasty Around Dental Implants: A Case Report

31 December 2025. pp. 242-249

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Abstract

Shallow vestibular depth with inadequate attached mucosa around dental implants can compromise peri-implant health and maintenance. This technical note describes a modified submucosal vestibuloplasty technique performed during second-stage implant surgery and demonstrates its clinical application. A 65-year-old woman received multiple implants in the bilateral posterior mandible with simultaneous guided bone regeneration. After a four-month healing period, second-stage surgery was performed using the modified technique. A midcrestal incision was made, followed by full-thickness flap elevation to expose the implant. The apical portion of the flap was then elevated as a superficial split-thickness flap, and the deeper connective tissue and periosteum were removed. Healing abutments were placed, and double horizontal mattress sutures were used to anchor the flap at the most apical level of the vestibule. The technique successfully restored vestibular depth and produced non-keratinized yet clinically attached mucosa with minimal morbidity. Compared with conventional approaches, such as an apically positioned flap with free gingival grafting or the Edlan–Mejchar technique, this modified approach offers greater simplicity and may reduce technique sensitivity and postoperative complications. However, long-term follow-up and histologic evaluation are required to confirm the stability of the newly formed vestibule and attached mucosa.

Keywords

Alveolar ridge augmentation

Bone regeneration

Dental implants

Oral mucosa

Vestibuloplasty

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