Kazanjian Vestibuloplasty – Indications and Surgical Protocol
The Kazanjian vestibuloplasty is a classical but still essential technique for deepening the vestibule and improving soft tissue conditions around dental prostheses and implants. It remains particularly useful in cases with reduced vestibular depth.
By repositioning the mucosal flap apically, this technique increases the attached gingiva and stabilizes the prosthetic environment.
Indications and Clinical Use
Kazanjian vestibuloplasty is indicated for:
- Shallow vestibules affecting prosthesis stability.
- Pre-prosthetic preparation before implant placement.
The procedure helps improve hygiene, prosthetic adaptation, and long-term implant maintenance by providing a stable, immobile soft tissue base.
Surgical Technique Overview
- Incision: A horizontal incision is made 10-12 mm below the mucogingival junction.
- Flap elevation: The mucosal flap is carefully separated from the underlying muscle until the mucogingival junction is reached.
- Muscle reflection: Muscle insertions are shaved and pushed down apically in order to leave only the periosteum.
- Apical repositioning: The mucosal flap is sutured apically to the periostium to create a deeper vestibule. (Notice the muscular layer in between them is no longer present).
Postoperative care includes chlorhexidine rinses and avoiding mechanical trauma for 10–14 days. Healing is generally rapid and predictable.
Advantages and Limitations
The Kazanjian technique is simple, effective, and has a high success rate when no muscle is left between the mucosal flap and the periosteum. However, it is contraindicated in cases with no keratinized mucosa or severe atrophy, where soft tissue grafts may be preferable.
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