Alveolar Mucosa-Switching Technique for Augmentation of the Attached Immobile Mucosa

In cases with a highly positioned mucogingival junction, an apically positioned flap in combination with palatal-mucosa grafting is commonly performed to deepen the sulcus. However, we believe that immobilizing the mucosa is more important than merely deepening it; thus, we developed a simple method based on the characteristics of its components. Elastic fiber should be replaced by collagen fiber. An apically positioned flap is no longer required and mobile alveolar mucosa, including elastic fibers, is just excised. Palatal-mucosa graft, including collagen fibers, is then performed. Mobile mucosa is switched to immobile mucosa, and histological evaluation supports this change. At the recipient site, simple excision of the mobile mucosa without an apically positioned flap is innovative.