Vestibular incisions A transoral approach is used for the majority of mandible body osteotomies. Mandibular body osteotomies are usually performed in the areas of the premolars and first molars. Sulcular incisions from the canine to the posterior molars with anterior and posterior extensions into the vestibule (marginal incisions, A) or paramarginal incisions may be used (B).
2. Vestibular incision
Unless contraindicated, infiltrate the area with a local anesthetic containing a vasoconstrictor. Make an incision along the gingival margin down to the alveolar crest.
For adequate exposure a broad based mucoperiosteal flap is dissected starting at the gingival margin. Dissecting downward, the mental foramen with the mental nerve needs to be identified and freed. The dissection is continued in the subperiosteal plane down to the lower border of the mandible.
4. Wound closure
After checking for hemostasis the wound is carefully sutured. Interdental sutures are used to reposition the papillae.