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Clinical Evaluation of Coronally Advanced Lingual Flap for Maintaining Primary Wound Closure over Titanium Mesh after Guided Bone Regeneration: A Randomized Control Trial

Rasha Attia, DMD, MS/Hani El-Nahass, DMD, MS, PhD/Maged Anis, DMD, MS/Manal Honsny, DMD, MS, PhD

DOI: 10.11607/prd.6179

Objectives: to evaluate the clinical efficacy, in terms of extent of lingual and buccal flap advancement, maintaining primary wound closure, and safety, of coronally advanced lingual flap (CALF) technique in comparison to buccal flap advancement alone during horizontal ridge augmentation in the posterior mandible. Material and methods: fourteen patients were randomly allocated to two different groups: buccal flap advancement referred as NO-CALF group (control), buccal flap advancement with CALF technique referred CALF group (test). Wound healing was monitored weekly for the first 4 weeks then at 2, 4, 6, and 9 months postoperatively for any soft tissue dehiscence along the incision line which identified as titanium mesh (TM) exposure. The extent of lingual and buccal flap advancement was measured, and any intraoperative and postoperative CALF-related complications were also reported. Results: The difference between groups was statistically significant (P value <.0001) in term of 1) TM exposure; CALF group showed no exposure while 83.3% of cases in NO-CALF group showed early Class П exposures, 2) the mean lingual flap advancement; 3.9 ± 1.1 mm and 14.4 ± 3.8 mm for the NO-CALF and CALF group respectively. 3) the mean buccal flap advancement; 15.8 ± 2.1 mm and 10.5 ± 1.4 mm for NO-CALF and CALF group respectively. No reported complications related to CALF technique. Conclusions: Tension free primary wound closure was facilitated and maintained during the healing period by applying CALF technique and it is a reliable technique to safely advance the lingual flap coronally. Int J Periodontics Restorative Dent. doi: 10.11607/prd.6179.

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