Management of Gingival Recession by the Use of an Acellular Dermal Graft Material: A 12-Case Series

2005 ◽  
Vol 76 (11) ◽  
pp. 1982-1990 ◽  
Author(s):  
A. Santos ◽  
G. Goumenos ◽  
A. Pascual
1999 ◽  
Vol 1 (1) ◽  
pp. 1-10 ◽  
Author(s):  
Robin D Henderson

Abstract This report describes a surgical technique for root coverage using an acellular dermal graft material and a coronally positioned flap. Video clips of a root coverage surgery are included using the graft material to cover multiple teeth in the same quadrant. Three additional completed cases are presented in which a mean root coverage of 97% was achieved, resulting in 100% coverage on 9 of 11 teeth. The results from this case series conform with the available evidence on the use of acellular dermal graft material in root coverage procedures.


Materials ◽  
2021 ◽  
Vol 14 (14) ◽  
pp. 3828
Author(s):  
Jung-Gu Ji ◽  
Jung-A Yu ◽  
Seong-Ho Choi ◽  
Dong-Woon Lee

Vertical ridge augmentation for long-term implant stability is difficult in severely resorbed areas. We examined the clinical, radiological, and histological outcomes of guided-bone regeneration using novel titanium-reinforced microporous expanded polytetrafluoroethylene (MP-ePTFE) membranes. Eighteen patients who underwent implant placement using a staged approach were enrolled (period: 2018–2019). Vertical ridge augmentation was performed in areas with vertical bone defects ≥ 4 mm. Twenty-six implant fixtures were placed in 14 patients. At implant placement six fixtures had relatively low stability. On cone-beam computed tomography, the average vertical changes were 4.2 ± 1.9 (buccal), 5.9 ± 2.7 (central), and 4.4 ± 2.8 mm (lingual) at six months after vertical ridge augmentation. Histomorphometric analyses revealed that the average proportions of new bone, residual bone substitute material, and soft tissue were 34.91 ± 11.61%, 7.16 ± 2.74%, and 57.93 ± 11.09%, respectively. Stable marginal bone levels were observed at 1-year post-loading. The residual bone graft material area was significantly lower in the exposed group (p = 0.003). There was no significant difference in the vertical height change in the buccal side between immediately after the augmentation procedure and the implant placement reentry time (p = 0.371). However, all implants functioned well regardless of the exposure during the observation period. Thus, vertical ridge augmentation around implants using titanium-reinforced MP-ePTFE membranes can be successful.


2021 ◽  
pp. 000313482110233
Author(s):  
Jordan Robinson ◽  
Jesse K. Sulzer ◽  
Benjamin Motz ◽  
Erin H. Baker ◽  
John B. Martinie ◽  
...  

Background Abdominal wall reconstruction in high-risk and contaminated cases remains a challenging surgical dilemma. We report long-term clinical outcomes for a rifampin-/minocycline-coated acellular dermal graft (XenMatrix™ AB) in complex abdominal wall reconstruction for patients with a prior open abdomen or contaminated wounds. Methods Patients undergoing abdominal wall reconstruction at our institution at high risk for surgical site occurrence and reconstructed with XenMatrix™ AB with intent-to-treat between 2014 and 2017 were included. Demographics, operative characteristics, and outcomes were collected. The primary outcome was hernia recurrence. The secondary outcomes included length of stay, surgical site occurrence, readmission, morbidity, and mortality. Results Twenty-two patients underwent abdominal wall reconstruction using XenMatrix™ AB during the study period. Two patients died while inpatient from progression of their comorbid diseases and were excluded. Sixty percent of patients had an open abdomen at the time of repair. All patients were from modified Ventral Hernia Working Group class 2 or 3. There were a total of four 30-day infectious complications including superficial cellulitis/fat necrosis (15%) and one intraperitoneal abscess (5%). No patients required reoperation or graft excision. Median clinical follow-up was 38.2 months with a mean of 35.2 +/− 18.5 months. Two asymptomatic recurrences and one symptomatic recurrence were noted during this period with one planning for elective repair of an eventration. Follow-up was extended by phone interview which identified no additional recurrences at a median of 45.5 and mean of 50.5 +/−12.7 months. Conclusion We present long-term outcomes for patients with high-risk and contaminated wounds who underwent abdominal wall reconstruction reinforced with XenMatrix™ AB to achieve early, permanent abdominal closure. Acceptable outcomes were noted.


2021 ◽  
pp. 229255032110499
Author(s):  
Rebecca Miller ◽  
Sheina Macadam ◽  
Daniel Demsey

Introduction and Purpose: Breast reconstruction is an active area of plastic surgery research. Citation analysis allows for quantitative analysis of publications, with more citations presumed to indicate greater influence. We performed citation analysis to evaluate the most cited papers on breast reconstruction between 2000 to 2010 to identify contemporary research trends. Methods: The SCI-EXPANDED database was used to identify the 50 most cited papers. Data points included authorship, publication year, publication journal, study design, level of evidence, number of surgeons/institutions, center of surgery, primary outcome assessed, implant/flap/acellular dermal matrix/fat graft, acellular dermal matrix brand and use with implants/flaps, fat graft use with implants/flaps, unilateral/bilateral, one-/two-stage, immediate/delayed, number of patients/procedures, complications. Descriptive analysis of trends was performed based on results. Results: 20% of papers were published in 2006, 16% in 2007 and 12% in both 2004/2009. 66% were published in Plastic and Reconstructive Surgery. The majority were retrospective or case series, and of Level III or IV evidence. The one Level I study was a prospective multicenter trial. 21 and 7 papers discussed procedures by single/multiple surgeons, respectively. Results from single/multiple centers were discussed in 18 and 6 papers, respectively. 30 papers discussed implant-based reconstruction, 22 papers flap-based (19 microsurgical), 15 papers acellular dermal matrix, and five papers fat grafting. The primary focus in the majority was complications or outcomes. Conclusion: Our analysis demonstrates continually evolving techniques in breast reconstruction. However, there is notable lack of high quality evidence to guide surgical decision-making in the face of increasing surgical options.


2018 ◽  
Vol 9 ◽  
pp. 20
Author(s):  
Shula Zuleika Sumana ◽  
Sri Lelyati C Masulili ◽  
Robert Lessang

Objective: This study aims to evaluate periodontal clinical conditions after treatment for gingival recession (GR) using subepithelial connective tissue graft (SCTG) and acellular dermal matrix (ADM).Methods: Ten patients with Miller’s Class I and II recessions that had been treated with SCTG or ADM at the Periodontics Outpatient Department at Universitas Indonesia were selected for this study. The pre-operative data for GR, clinical attachment levels (CAL), and attached gingiva (AG) were retrieved from the patients’ medical records. The patients were recalled and the post-operative data were recorded.Results: The application of SCTG and ADM yields significant changes to GR, CAL, and AG levels. A comparison of two groups at the post-operative assessment stage showed no statistically significant differences, in terms of GR, CAL, and AG.Conclusion: SCTG and ADM yield similar outcomes in the treatment of GR. As such, ADM may be suggested as an alternative to SCTG for root coverage.


2013 ◽  
Vol 24 (6) ◽  
pp. 565-568 ◽  
Author(s):  
Danilo Maeda Reino ◽  
Arthur Belem Novaes Jr. ◽  
Marcio Fernando de Moraes Grisi ◽  
Luciana Prado Maia ◽  
Sergio Luis Scombatti de Souza

Subepithelial connective tissue graft (SCTG) has been extensively used for a variety of clinical applications. However, the surgical procedure may not allow control of graft thickness. The purpose of this case series is to illustrate a modification to the single incision palatal harvesting technique in order to control the SCTG thickness without increasing patient discomfort. Fifty cases from thirty systemically and periodontally healthy patients with at least one multiple gingival recession were treated with coronally advanced flaps combined with a SCTG. The palatal area served as the donor site, from where a single perpendicular incision was made to obtain a full thickness flap. Next, 1-2 mm of the flap was elevated and dissected to obtain a partial thickness flap. The graft remained attached to the full-partial thickness flap. After determining the desired SCTG thickness, the graft was harvested from the palatal flap. The patients healed uneventfully at 7 days postoperatively and primary closure was obtained for all palatal donor sites. The SCTG length and width varied depending on the needs of each case, but the SCTG thickness was well controlled with only 0.24 mm standard deviation. The suggested modification granted control of the SCTG dimensions and achieved complete wound closure within a week.


2020 ◽  
Vol 10 ◽  
pp. 3-11
Author(s):  
Tae-Kyung Kim ◽  
Seung-Hak Baek

Objective: The objective of the study was to describe the types, causes, and recommendations for the prevention/ management of complications related with lingual bonded retainers (LBRs) during the retention period. Materials and Methods: The retention protocol was a combined use of the LBRs made from 0.0175 multistrand wire and bonded on the maxillary and mandibular anterior teeth by DuraLay resin transfer method and a removable retainer at both arches for nighttime wear. Nine cases, which did not show bonding failure or fracture of LBR, were described to explain the complications including unexpected tooth movements and gingival problems. Results: The types of complications were spacing, loss of alignment, change in transverse position, angulation or torque of the crown, gingival recession, and black triangle. There are three possible causes for these complications: (1) Active force generated by LBR, which was not passively fabricated or bonded, (2) deformation of LBR induced by heavy biting force or traumatic occlusion, and (3) untwisting force of strand in round flexible multistrand wire. These complications can be prevented or managed by (1) fabrication of LBR on a working model to make it passive, (2) use of a jig to position LBR during bonding to avoid deformation by finger pressure, (3) supplemental use of a removable retainer for nighttime wear, (4) early detection of bonding failure, deformation, or fracture of LBR, and (5) immediate removal of LBR and use of a new removable retainer for resolution of complications. Conclusion: Clinicians should check the existence of these complications from the start of retention and inform the patient of the possibility of retreatment.


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