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Microvascularisation of The Mucosa in The Lower Jaw as a Guide For Flap Design and Soft Tissue Healing
EAO Online Library. Gashi Cenkoglu B. Oct 9, 2018; 232570; P-BR-24
Brunilda Gashi Cenkoglu
Brunilda Gashi Cenkoglu
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The understanding of human anatomy has changed dramatically. Despite the routine use of intraoral flaps of the oral cavity, very few investigations have been centered on understanding microvascularisation of the oral cavity. This study focuses on the blood supply of mucosa in the lower jaw to add further information about soft tissue management during dental implantology and eventually to avoid creating avascular zones of the gingiva, which in return would result in severe problems in healing.The aim of this study was to evaluate the blood supply of the alveolar ridge in the lower jaw which represents the fundamentals for flap design and soft tissue healing.The investigation was carried out in thirty human cadavers embalmed by the Graz Embalming Procedure by Walter Thiel. The gender distribution was 45% female and 55% male with an average age of 72 years. First, the exposure of the external carotid artery and the depiction of the departures took place. After the preparation, the vessels were cannulated and injected slowly with even pressure. The lingual, facial and infra-alveolar arteries were exposed and either Indian ink or a colored resin was injected. The alveolar ridge supplying, delicate vessels are shown in their natural position.The varying colorisations show the specific vascularisation. The vestibular posterior part of the mandible is supplied by the facial artery, the vestibular anterior part by the inferior labial artery and additionally by the mental artery. An almost avascular zone is found at the alveolar crest. This separates the area supplied by the facial artery from the area nourished by the lingual artery. The incision of choice in edentulous mandibles should be localised in the middle of the alveolar ridge. Due to the non-vascularised zone located there is a protection to ensure the jaw ridge tapering vessels.The study clearly shows that the alveolar crest in edentulous regions and the gingival margin are the primary sites for incisions due to the reduced vascularisation. This results in a minimal surgical trauma to the tissue and to less bleeding. Postoperative healing will be not impaired by injured blood vessels.
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