Options to avoid the second surgical site: a review of literature

Abstract

As esthetics gain importance, periodontal plastic surgical procedures involving soft tissue grafts are becoming commoner both around natural teeth as well as around implants. Periodontal soft tissue grafts are primarily used for the purpose of root coverage and in pre-prosthetic surgery to thicken a gingival site or to improve the crestal volume. Soft tissue grafts are usually harvested from the palate. Periodontal plastic surgical procedures involving soft tissue grafts harvested from the palate have two surgical sites; a recipient site and another donor site. Many patients are apprehensive about the soft tissue graft procedures, especially the creation of the second/donor surgical site in the palate. In the past decade, newer techniques and products have emerged which provide an option for the periodontist/patient to avoid the second surgical site. MucoMatrixX, Alloderm(®), Platelet rich fibrin, Puros(®) Dermis and Mucograft(®) are the various options available to the practicing periodontist to avoid the second surgical site. Use of these soft tissue allografts in an apprehensive patient would decrease patient morbidity and increase patient's acceptance towards periodontal plastic surgical procedures.

Evaluation of the Biological Behavior of Mucograft® in Human Gingival Fibroblasts: An In Vitro Study

“…This layer not only protects against bacterial infiltration during open healing conditions, it also contains adequate elastic properties to accommodate suturing. The second layer consists of a thick, porous, spongy collagen structure, which is placed next to the host tissues to facilitate organization of the blood clot and promote neoangiogenesis and tissue integration (5,6).…”

Leucocyte Platelet Rich Fibrin with Autologous Gingival Fibroblasts in the Treatment of Adjacent Recession Defects

“…Complete root coverage is the biggest challenge of any surgical technique used at present in periodontal plastic surgery (Thoma et al, 2009). In a review, Ramachandra et al (2014), presented possible complications associated when classic palatal and free gingival graft technique was applied and how this procedure is rejected by several patients. Throughout their work, they finally propose various alternatives for soft tissue grafts with newer techniques and also with new biomaterials that can promote cellular proliferation to enhance wound Fan et al (2013) studied the biological behavior (proliferation, migration and expression of collagen I) of human gingival fibroblasts with PRF.…”

Histological and immunohistochemical comparison of two different allogeneic bone grafting materials for alveolar ridge reconstruction: A prospective randomized trial in humans

“…Maxgraft is a pooled allogeneic material from multiple donors and finally dehydrated by freeze‐drying, whereas Puros is an allogeneic material harvested from one single donor per batch and is dehydrated using a solvent dehydration process prior to packaging and gamma‐irradiation. Each process has been validated to inactivate viruses and bacteria and preserve the natural collagen‐bone mineral composition which prevents disease transmission by removing and/or inactivating cells, viruses, antigens, and pathogens …”

“…Each process has been validated to inactivate viruses and bacteria and preserve the natural collagen-bone mineral composition which prevents disease transmission by removing and/or inactivating cells, viruses, antigens, and pathogens. 16 Biopsy collection and experiments were performed in compliance with the World Medical Association Declaration of Helsinki (version 2008) and were approved by an ethics committee (Hamburg Medical Association, Germany, no. PV5211) and the study was registered with the German Register for Clinical Trials (DRKS no.…”