Buccal periosteal inversion (BUPI) for defect closure and keratinized gingiva width preservation after tooth extraction – technique modification
Introduction: Several techniques and methods have been proposed to cover alveolar bone after tooth extraction when soft tissue is lacking. Some authors recommend soft tissue flap techniques, and others advocate different types of materials for socket covering. In this article, the authors use a modi...
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Springer
2021-12-01
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| Series: | Saudi Dental Journal |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1013905221000560 |
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| author | Ivan Hristov Arabadzhiev Peter Maurer Eber Luis de Lima Stevao |
| author_facet | Ivan Hristov Arabadzhiev Peter Maurer Eber Luis de Lima Stevao |
| author_sort | Ivan Hristov Arabadzhiev |
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| description | Introduction: Several techniques and methods have been proposed to cover alveolar bone after tooth extraction when soft tissue is lacking. Some authors recommend soft tissue flap techniques, and others advocate different types of materials for socket covering. In this article, the authors use a modified buccal inversion technique for adequate coverage of the alveolar ridge to ensure its preservation and to minimize soft tissue shrinkage and loss of keratinized gingiva after tooth extraction. This local mucogingival-periosteal plastic procedure was named by the authors the “Buccal Periosteal Inversion technique” or simply BUPI. Materials and Methods: After extraction of a fractured, endodontically compromised lower right first molar, the BUPI technique was performed to cover the alveolus. After reflecting the two-sided full-thickness flap, the periosteum was split in the cranial direction. The inverted periosteum is used to provide tension-free defect closure of the postextractional defect. Detailed technique implementation and patient postoperative healing are presented here in detail. Results: Postoperative evaluation at six weeks was presented with photos showing adequate surgical site healing, no signs of infection or dehiscence, and no crestal shift of the keratinized gingiva. Conclusion: The buccal periosteal inversion (BUPI) technique is a modified technique that allows full socket coverage, avoiding a keratinized gingiva shift in the crestal direction using only the periosteum as a cover material. By inverting the buccal ridge periosteum alone from its normal position, the osteoclastic effect on the buccal bony wall will be eliminated, and this procedure abolishes the need for additional alveolar coverage materials. |
| format | Article |
| id | doaj-art-c2db0973edc64533b57a94bb66ba804e |
| institution | OA Journals |
| issn | 1013-9052 |
| language | English |
| publishDate | 2021-12-01 |
| publisher | Springer |
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| series | Saudi Dental Journal |
| spelling | doaj-art-c2db0973edc64533b57a94bb66ba804e2025-08-20T01:55:41ZengSpringerSaudi Dental Journal1013-90522021-12-013381049105410.1016/j.sdentj.2021.05.004Buccal periosteal inversion (BUPI) for defect closure and keratinized gingiva width preservation after tooth extraction – technique modificationIvan Hristov Arabadzhiev0Peter Maurer1Eber Luis de Lima Stevao2Master of Dental Medicine; Master of Public Healthcare and Healthcare Management; Resident in Oral Surgery at Praxisklinik Prof. Dr. Dr. Peter Maurer in Sankt Wendel – Saarland, Germany. (At Time of the Technique Development); Corresponding author at: Roeschstr 24, Schwandorf, Germany.Medical Doctor; Dental Doctor; OMF surgeon at Praxisklinik Prof. Dr. Dr. Maurer in Sankt Wendel – Saarland, GermanyDoctor of Dental Surgery, OMF surgeon, PhD in OMFS, PostDoctoral at Baylor University Medical Center and Baylor College of Dentistry, Dallas, TX, USAIntroduction: Several techniques and methods have been proposed to cover alveolar bone after tooth extraction when soft tissue is lacking. Some authors recommend soft tissue flap techniques, and others advocate different types of materials for socket covering. In this article, the authors use a modified buccal inversion technique for adequate coverage of the alveolar ridge to ensure its preservation and to minimize soft tissue shrinkage and loss of keratinized gingiva after tooth extraction. This local mucogingival-periosteal plastic procedure was named by the authors the “Buccal Periosteal Inversion technique” or simply BUPI. Materials and Methods: After extraction of a fractured, endodontically compromised lower right first molar, the BUPI technique was performed to cover the alveolus. After reflecting the two-sided full-thickness flap, the periosteum was split in the cranial direction. The inverted periosteum is used to provide tension-free defect closure of the postextractional defect. Detailed technique implementation and patient postoperative healing are presented here in detail. Results: Postoperative evaluation at six weeks was presented with photos showing adequate surgical site healing, no signs of infection or dehiscence, and no crestal shift of the keratinized gingiva. Conclusion: The buccal periosteal inversion (BUPI) technique is a modified technique that allows full socket coverage, avoiding a keratinized gingiva shift in the crestal direction using only the periosteum as a cover material. By inverting the buccal ridge periosteum alone from its normal position, the osteoclastic effect on the buccal bony wall will be eliminated, and this procedure abolishes the need for additional alveolar coverage materials.http://www.sciencedirect.com/science/article/pii/S1013905221000560PeriosteumPeriosteal inversionPeriosteum inversionBuccal ridge preservationAlveolar protection |
| spellingShingle | Ivan Hristov Arabadzhiev Peter Maurer Eber Luis de Lima Stevao Buccal periosteal inversion (BUPI) for defect closure and keratinized gingiva width preservation after tooth extraction – technique modification Saudi Dental Journal Periosteum Periosteal inversion Periosteum inversion Buccal ridge preservation Alveolar protection |
| title | Buccal periosteal inversion (BUPI) for defect closure and keratinized gingiva width preservation after tooth extraction – technique modification |
| title_full | Buccal periosteal inversion (BUPI) for defect closure and keratinized gingiva width preservation after tooth extraction – technique modification |
| title_fullStr | Buccal periosteal inversion (BUPI) for defect closure and keratinized gingiva width preservation after tooth extraction – technique modification |
| title_full_unstemmed | Buccal periosteal inversion (BUPI) for defect closure and keratinized gingiva width preservation after tooth extraction – technique modification |
| title_short | Buccal periosteal inversion (BUPI) for defect closure and keratinized gingiva width preservation after tooth extraction – technique modification |
| title_sort | buccal periosteal inversion bupi for defect closure and keratinized gingiva width preservation after tooth extraction technique modification |
| topic | Periosteum Periosteal inversion Periosteum inversion Buccal ridge preservation Alveolar protection |
| url | http://www.sciencedirect.com/science/article/pii/S1013905221000560 |
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