Pedicle flaps in implant surgery

(Two novel techniques utilizing pediculated connective tissue graft)

The pedicle connective tissue graft (PCTG) has its own blood supply maintained, therefore, allowing graft survival on the poorly vascularized and nonvascularized recipient site.

A palatal pedicle connective tissue graft is an essential element of mIVAN technique (modified Interpositional Vascularized Augmentation Neogenesis). mIVAN technique is the technique for simultaneous hard and soft tissue grafting used for (1) flap-less hard and soft tissue augmentation in extraction sockets with missing labial bone or (2) hard/soft tissue augmentations with simultaneous implant placement for ridges demonstrating horizontal atrophy in the esthetic zone.

Buccal sliding palatal pedicle flap (BSPPF) In the maxilla, a buccal sliding palatal flap can be applied for primary wound closure after ridge augmentation. The dissected part of the palatal connective tissue is left exposed thus eliminating or reducing the amount of the coronal flap advancement respectively and increasing the amount of keratinized gingiva. In combination with guided soft tissue augmentation, this flap design enables a three-dimensional peri-implant soft tissue augmentation.