Acellular dermal matrix allograft versus free gingival graft: a histological evaluation and split-mouth randomized clinical trial

Resende, Daniel Romeu Benchimol de; Greghi, Sebastião Luiz Aguiar; Siqueira, Aline Franco; Benfatti, César Augusto Magalhães; Damante, Carla Andreotti; Zangrando, Mariana Schützer Ragghianti

doi:10.1007/s00784-018-2470-6

Cited by 53 publications

(63 citation statements)

References 24 publications

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“…4,9,10 In dentistry, ADM was firstly evaluated for increasing attached and/or keratinized gingivae. 12,13 In particular, the ADM seems to be more prone to shrinkage, which may also explain the reduced tissue thickness observed. 12,13 In particular, the ADM seems to be more prone to shrinkage, which may also explain the reduced tissue thickness observed.…”

Section: Decellularized Human Dermismentioning

confidence: 97%

“…12,13 In particular, the ADM seems to be more prone to shrinkage, which may also explain the reduced tissue thickness observed. 5,13 Histological data of sites treated with ADM show a "scar" tissue appearance, 6 although better esthetic and color match with the surrounding tissue has been described, when compared with a FGG. 5,6,13 Currently, the ADM is more routinely used for root coverage procedures ( Fig.…”

Section: Decellularized Human Dermismentioning

confidence: 97%

“…11 However, the ADM clinical outcomes are inferior to the free gingival graft (FGG). 5,13 Histological data of sites treated with ADM show a "scar" tissue appearance, 6 although better esthetic and color match with the surrounding tissue has been described, when compared with a FGG. 5,13 Histological data of sites treated with ADM show a "scar" tissue appearance, 6 although better esthetic and color match with the surrounding tissue has been described, when compared with a FGG.…”

Section: Decellularized Human Dermismentioning

confidence: 99%

“…2), [14][15][16][17][18][19] particularly when avoiding a second surgical site and minimizing patient morbidity is the primary concern. 19 Similarly, a 12-year follow-up study reported a significant relapse of the gingival margin in multiple gingival recessions treated with ADM. 17 A possible mechanism may be that the ADM may not have the capability of inducing keratinization of the overlying epithelia, 5,7,13 which seems to be a positive predictor for the stability of the gingival margin. 19 Similarly, a 12-year follow-up study reported a significant relapse of the gingival margin in multiple gingival recessions treated with ADM. 17 A possible mechanism may be that the ADM may not have the capability of inducing keratinization of the overlying epithelia, 5,7,13 which seems to be a positive predictor for the stability of the gingival margin.…”

Section: Decellularized Human Dermismentioning

confidence: 99%

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Extracellular matrix‐based scaffolding technologies for periodontal and peri‐implant soft tissue regeneration

Tavelli

McGuire

Zucchelli

et al. 2019

Journal of Periodontology

117

141

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The present article focuses on the properties and indications of scaffold‐based extracellular matrix (ECM) technologies as alternatives to autogenous soft tissue grafts for periodontal and peri‐implant plastic surgical reconstruction. The different processing methods for the creation of cell‐free constructs resulting in preservation of the extracellular matrices influence the characteristics and behavior of scaffolding biomaterials. The aim of this review is to discuss the properties, clinical application, and limitations of ECM‐based scaffold technologies in periodontal and peri‐implant soft tissue augmentation when used as alternatives to autogenous soft tissue grafts.

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Section: Decellularized Human Dermismentioning

confidence: 97%

Section: Decellularized Human Dermismentioning

confidence: 97%

Section: Decellularized Human Dermismentioning

confidence: 99%

Section: Decellularized Human Dermismentioning

confidence: 99%

See 2 more Smart Citations

Extracellular matrix‐based scaffolding technologies for periodontal and peri‐implant soft tissue regeneration

Tavelli

McGuire

Zucchelli

et al. 2019

Journal of Periodontology

117

141

View full text Add to dashboard Cite

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“…of graft substitutes, 8 as well as the associated higher shrinkage over time. 9 On the other hand, CTG acts as a biological filler to enhance the flap adaptation to the root surface and to increase gingival thickness. 10 In a systematic review and meta-analysis, Thoma et al concluded that autogenous grafts (either CTG or FGGT) were the most effective technique in augmenting keratinized mucosa at implant sites, 7 a crucial factor for maintaining peri-implant health.…”

mentioning

confidence: 99%

The influence of palatal harvesting technique on the donor site vascular injury: A split‐mouth comparative cadaver study

Tavelli

Barootchi

Namazi

et al. 2019

Journal of Periodontology

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Background The aim of this study was to evaluate the influence of two harvesting approaches on the donor site vascular injury. Methods A split‐mouth cadaver study was designed on 21 fresh donor heads. Every hemi‐palate was assigned to receive the trap‐door harvesting technique (TDT) or the epithelialized free gingival graft harvesting technique (FGGT). A soft tissue graft was harvested from each side for histology analyses. Betadine solution was used to inject the external carotid artery and a collagen sponge was positioned over the harvested area to compare the amount of “leakage.” Results The mean leakage observed was 16.56 ± 3.01 µL in the FGGT‐harvested sites, and 69.21 ± 7.08 µL for the TDT group, a ratio of 4.18 (P < 0.01). Regression analyses demonstrated a trend for more leakage at thinner palatal sites for the FGGT group (P = 0.09), and a statistically significant correlation for the TDT‐harvest sites (P = 0.02). Additionally, a shallow palatal vault height (PVH) was associated with a higher leakage in both harvesting groups (P = 0.02). The histomorphometric analyses revealed that grafts harvested with TDT exhibited a significantly higher mean number of medium (ø = 0.1 to 0.5 mm, P = 0.03), and large vessels (ø ≥ 0.5 mm, P = 0.02). Conclusions Within the limitations of the present research, the TDT resulted in a significantly higher leakage than the FGGT, which was also correlated with the histology analyses where a greater number of medium and large vessels were observed in the harvested grafts.

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Treatment of peri‐implant soft tissue dehiscence around implants placed in calvarial bone graft maxilla and mandible 20 years ago: A case report

Watanabe

Tanimura²

2022

Clin Adv Periodontics

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IntroductionDespite tissue augmentation and management prior implantation, long‐term observation can reveal a change in peri‐implant phenotype with some lack of keratinized mucosa (KM). The treatment approach of peri‐implant dehiscence in multiple implants is not clearly defined. This report describes the different periodontal surgical approaches undertaken to promote the gingival margin stability and to prevent the peri‐implant mucosal inflammation over time.Case PresentationA 64‐year‐old woman with peri‐implant tissue dehiscence regarding implants placed 20 years ago in a calvarial bone grafted maxilla and mandible was treated. Right maxillary and mandible peri‐implants soft tissue were treated with a large apically positioned partial‐thickness flap (APPTF) combined to a free gingival graft (FGG) simultaneously. For the left maxillary, where a frenum was in tension associated with infection and pockets, a large APPTF followed by a FGG 4 months later were performed. The KM width (KMW) increased in three operated sites with a gain average of 2.2 mm. The plaque control record decreased from 68% to 21%. All the probing depths were lower than 3 mm. Bleeding on probing was significantly reduced. The gingival index (GI) went from 1.5 to 0.25.ConclusionIn a multiple implants soft tissue dehiscence case, an APPTF associate to a FGG, delayed or not, seems to be a safety primary approach to improve the KMW and to stabilize the peri‐implants soft tissue. Further, a connective tissue graft in a bilaminar approach could be an option to enhance soft tissue thickness and esthetic outcomes.Key pointsWhy is this case new information? To the best of the authors' knowledge, there are very limited studies regarding multi‐implant soft tissue dehiscence treatment. Relevant guidelines are not clearly defined. Despite peri‐implant hard and soft tissue augmentation, after a long‐term observation (20 years of function), we can observe a change in peri‐implant soft tissue phenotype (PISTP) with periodontal complication. What are the keys to successful management of this case? Removal of peri‐implant infection and tissue tension (frenum) by a large apically positioned partial‐thickness flap (APPTF) before soft tissue augmentation procedure. In case of very thin peri‐implant soft tissue, caution is needed to preserve the blood supply from the supra‐periosteal plexus. Large APPTF and sufficient amount of keratinized mucosa (KM) should be grafted to compensate for the tissue shrinkage. What are the primary limitations to success in this case? High esthetic demand. A secondary bilaminar approach with a connective tissue graft (CTG) should be necessary to improve the esthetic outcomes. Patient compliance.

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Acellular dermal matrix allograft versus free gingival graft: a histological evaluation and split-mouth randomized clinical trial

Abstract: This study added important clinical and histological data to contribute in the decision-making process between indication of FGG or ADM.

Cited by 53 publications

References 24 publications

Extracellular matrix‐based scaffolding technologies for periodontal and peri‐implant soft tissue regeneration

Extracellular matrix‐based scaffolding technologies for periodontal and peri‐implant soft tissue regeneration

The influence of palatal harvesting technique on the donor site vascular injury: A split‐mouth comparative cadaver study

Treatment of peri‐implant soft tissue dehiscence around implants placed in calvarial bone graft maxilla and mandible 20 years ago: A case report

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