is a surgical procedure designed to deepened oral vestibule by changing soft
tissue attachments. Various surgical modalities have been used for
vestibuloplasty including sub mucosal vestibuloplasty, secondary epithelisation
technique, Edlan-Mejchar vestibuloplasty) and
soft tissue grafting vestibuloplasty.
Mejchar technique was given by Edlan and B Mejchar (1963) and it is secondary epithelisation
vestibuloplasty. In secondary epithelisation the mucosa of vestibule is used to
line one side of the extended vestibule, and the other side heals by growing
new epithelial surface. Edlan and Mejchar technique is a modification of
Mejchar depicted a technique for vestibuloplasty which was applicable to
patients in whom there were no pockets and little or no gingival tissue
present. This procedure also increases the width of the attached gingiva where
other procedures were impracticable due to lack of vestibular depth.2,3,4 This
technique is also indicated in treatment of localized recession or for elimination
of a broad, high frenum.
Mejchar technique known as lip switch procedure or transpositional flap or
Edlan vestibuloplasty. The advantage of this technique no bone is left exposed,
it minimizes the chances of bone resorption and further recession. Another
advantage of this technique is there are no relapses of the vestibule and scar
formation is minimal. In the present case, an excellent clinical result was obtained
which was maintained even 3 month after surgery.
Several techniques have been developed since
1956, but most of them are unsatisfactory due to scar formation and frequent
relapse of the state of the vestibule.
associated with shallow vestibule is improper maintenance of oral hygiene
because of traumatic brushing. Various brushing techniques require the
placement of the toothbrush at the gingival margin, which may not be possible
with reduced vestibular depth. It has been reported that with minimal of 1 mm
of attached gingiva, proper gingival health cannot be established.
Compared to another
widely used periosteal fenestration technique there is minimal contraction of
the vestibular depth gained and minimal scar formation. 5
This finding is
consistent with the observations of Wade (1969)6. A study done by Axel
Ergenholtz and Anders Hugoson stated that net gain was of 7.7 mm which was followed
upto 5 years. The condition was stabilized and maintained.3