Unsupported Hypermobile Tissue
Excessive hypermobile tissue without inflammation on he. alveolar ridge is generally the result of resorption of the underlying bone, ill-fitting dentures, or both. Before the excision of this tissue,·a determin tion must be made
of whether the underlying bone sho~ld be augmented with a graft. If a bony deficiency is the primary cause of. soft tissue excess, then. augmentation of the underlying bo~ is the treatment of choice. If adequate alveolar
height remains after reduction of the hypermobile soft . tissue, then excision may be indicated.Alocal anesthetic is injected adjacent to the area requiring tissue excision. Removal of llypermobile tissue in thealveolar
ridge area consists of two. parallel full-thickness incisions on the buccal and Itngual-sspects of the tissue tobe excised’ (Fig. 13-20). A periosteal elevator is used fo, remove the excess soft tissue from the underlying bone. A-u
tangential excision of small amounts of tissue in the adjacent areas may be necessary to allow for adequate soft tissue adaptation during closure. These additional excisions should.be kept to a minimum whenever possible to avoid removing too much softtissue and to prevent detachment of periosteum from underlying bone. Continuous or interrupted sutures are used to approximate the remaining tissue and are removed 7 days after surgery, Denture impressions can usually be taken 3 to 4 weeks after surgery’ possible complication of this type of procedus.
obliteranon of the buccal vestibule as a result of tissue undermining necessary to obtain tissue closure. . Hyperinobile tissue in the crestal area of the mandibular alveolar ridge frequently consists of a small cordlike
band of tissue. If n o underlying sharp bony projection is present, this tissue can best be removed by a supraperiosteal soft tissue excision. Local. anesthetrc is injected adjacent to the area requiring tissue removal. The cordlike band of fibrous connective tissue caa be elevated by using pickups and scissors, and the scissors”<:an be used to excise the fibrous tissue at the attachment. to the alveolar ridge (Fig. 13-21), Generally, no suturlrrgts necessary for this terhrrique, and a denture with a soft liner can be