Role for sulcus deepening suturesin reconstructive surgery

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British Journal of Oral and Maxillofacial Surgery (2002) 40, 262–266 © 2002 The British Association of Oral and Maxillofacial Surgeons

BRITISH

Journal of Oral and Maxillofacial Surgery

Letters to the Editor doi: 10.1054/bjom.2001.0655, available online at http://www.idealibrary.com on

ROLE FOR SULCUS DEEPENING SUTURES IN RECONSTRUCTIVE SURGERY Sir, We read with interest the note by W. Halfpenny1 regarding the use of sulcus deepening sutures following ablation of oral malignancy of the tongue, floor of mouth and adjacent mandible. We support the use of such sutures but advocate a two-stage procedure concentrating on ensuring flap viability at the initial surgery. As a secondary procedure, we have found that the soft tissue

Fig. 3 Revised flap buccal view.

excess overlying the mandibular ridge, following free tissue transfer, can be reduced by the removal of the subdermal fat. At the same time, an opportunity exists to insert simple mandibular bolster sutures in order to produce a lingual sulcus (Fig. 1). We have found that using this technique a thinned and revised flap will readily adapt to the mandibular contour and the lingual sulcus produced is suitable for the retention of dentures, be they tissue, tooth-borne or implant-retained (Figs 2 & 3). N. R. Saeed Specialist Registrar D. R. Cunliffe Specialist Registrar S. R. Watt-Smith Consultant Department of Oral and Maxillofacial Surgery John Radcliffe Hospital Oxford OX3 9DZ, UK

Fig. 1 Diagram showing mandibular bolster sutures in place.

REFERENCE 1. Halfpenny W. Role for sulcus deepening sutures in reconstructive surgery. Br J Oral Maxillofac Surg 2000; 38: 608–609.

Fig. 2 Revised flap with lingual sulcus allowing denture construction.

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