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Vestibuloplasty
Loss of alveolar bone as mentioned before makes dentures not fit well. The denture needs a certain amount of ridge height to give it retention. Besides making the ridge bigger by adding bone one can also move the unattached (cheek tissues) gingiva away from the ridge. The vestibule is that part between the cheek and gums. Plasty of the vestibule can be done by various methods, the most reliable of which is grafting tissue obtained from another area.
This could be obtained from the roof of mouth or the skin. The skin tissue can be obtained in a manner called split thickness or full thickness. When split thickness tissue is obtained it is usually taken from the thigh. A special cutting tool called a dermatome is used to take a very thin (0.015 inch) rectangle of skin. The skin grows back but will usually leave a slightly noticeable patch of different color and texture when healed. The full thickness graft must be obtained from non-hair bearing tissue. An excellent accompanying procedure is to perform blepharoplasty (eyelid surgery) and to transfer the excised tissue to the mouth. The patient can gain tissue where it’s needed and remove unwanted tissue all at once.
The roof of the mouth (hard palate) is an excellent source of attached gingiva (gums). The tissue is the same type and thickness of the needed tissue and its source, the palate, is a renewable source. A graft taken from the palate leaves a patch which will completely grow back and can be used again in the future. The drawback to this procedure is that it is fairly painful. Of course, prescription for strong pain medicines is provided and a plastic shield is made to fit over the palate to protect it and decrease the pain.