Lip Travel Reduction

Part 2 - Dissecting the epithelium and why this should not be rushed.

Instructors:

Michael Skinner, DDS

Michael Skinner, DDS

Michael Skinner, DDS, a Board Certified Diplomate of the American Academy of Periodontology, is the founder of The Advanced Institute For Oral Health and is engaged in full time private practice of periodontics and implantology in Brentwood, Tennessee. Dr. Skinner has over 18 years of experience dedicated strictly to periodontology and implantology.

Dr. Skinner demonstrates the dissection of the epithelium in this section of the dental continuing education course.

Then using a 15 we dissect the 1.5 mm epithelium from the entire vestibule so that can be sutured with connective tissue to connective tissue, that's done in the layered closure technique using resorbable 4.0 chromic gut sutures, primary closure of the flap is preformed with 5.0 vicryl. So you can see at this point from the midline we have de-epithelialized the vestibule exposing connective tissue that we will then suture together so that it can heal and we are going to reduce the vestibular depth to minimize lip travel so now we'll do the same procedure on the left hand side. Dr. Skinner will now do the same thing on the other side. It seems obvious but cannot be overstated. This cannot be rushed and you must be careful doing so. This is what we did for "Extreme Makover." We have completed the de-epithelialization of the vestibule and now those margins can be sutured together and the connective tissue can heal to obliterate the vestibule but in addition now we're going to do a connective tissue graft to reduce the concavity of the apex of the incisor teeth. We're going to go to the roof of the mouth. You doing OK, Z. You're doing well.