Hydroxyapatite augmentation of the anterior portion of the maxilla with a modified transpositional flap technique.

Tunneling as a technique for augmentation of an atrophic maxilla has been described in the literature. The use of this technique has presented several prosthodontic problems, such as diffusion of material into adjacent tissues, incorrect positioning of the material on the ridge, and inadequate ridge height. Use of the transpositional flap technique described by Lew and modified by Williams has been used to overcome these problems. Twenty-five patients were treated with this method during a 30-month period. The patients had worn a maxillary complete denture for at least 5 years and had opposing natural mandibular anterior teeth with unsupported posterior occlusion. Use of the transpositional flap technique was shown to overcome the common prosthodontic problems seen with the tunneling procedure for anterior maxilla augmentation with hydroxyapatite.