The Novel Periosteal Flap Stretch Technique: A Predictable Method to Achieve and maintain Primary Closure in Augmentative Procedures.

BACKGROUND: Correct soft tissue management and achieving tension-free primary closure are pre-requisites for the success of bone augmentation procedures. Several techniques have been developed to facilitate a passive soft tissue primary closure. However, the current techniques are highly invasive and require advanced surgical skills. Hence, the present case series report will describe a novel and simple flap management technique. METHODS: The Periosteal Flap Stretch technique was utilized in bone augmentation procedures for four patients who presented with horizontal and vertical alveolar ridge deficiencies in the anterior maxilla, anterior mandible, posterior mandible, and posterior maxilla. This technique is performed using a blunt surgical curette that engages the periosteum of the mucosa below the mucogingival line of the full-thickness flap and stretches the periosteum in a coronal and outward direction, which results in stretching of the flap without the need for vertical or periosteal releasing incisions. RESULTS: Healing was uneventful for four all cases. No membrane exposure, no soft tissue dehiscence, or any other complications were observed during the six-months healing period after the respective bone augmentation procedures of cases. CONCLUSIONS: The Periosteal Flap Stretch technique is a novel and simple technique that facilities achieving passive and predictable primary soft tissue closure.