Gain of Keratinized Mucosa Around Teeth and Dental Implants Using a Combination of Strip Gingival Graft and Acellular Dermal Matrix
Gingival Recession, Lack of Keratinized Attached Peri-implant Mucosa, Thin Gingiva
About this trial
This is an interventional treatment trial for Gingival Recession focused on measuring Attached mucosa, Keratinized tissue, Dental implants, Connective tissue
Eligibility Criteria
Inclusion Criteria:
- English speaking
- At least 18 years old
- Able to read and understand informed consent document
- Patients with teeth/implants lacking keratinized tissue.
- Must be a patient of the UAB Dental School
- Presence of periodontally healthy, non-carious neighboring teeth, healthy implants or edentulous ridges on either side of the involved site(s)
Exclusion Criteria:
- Non-English speaking
- Less than 18 years old
- Smokers/tobacco users (>10 cigarettes/day)
- Patients with systemic pathologies or conditions contraindicating oral surgical procedures or adversely affecting wound healing
- Presence of active periodontal disease
- Previous soft tissue grafting at the site(s) to be treated
Sites / Locations
- Unversity of Alabama at Birmingham, School of DentistryRecruiting
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Strip Free gingival graft (SGG) + Acellular Dermal Matrix graft (ADM)
Free gingival graft.
A horizontal incision is then placed at the middle of residual KT. Two vertical releasing incisions are followed to allow for apical displacement of the flap. The recipient site should ideally retain intact periosteum that is firmly attached to bone with no loose fibers, no irregularities and no perforations. A strip of a free gingival graft is then harvested from the patient's palate. This strip is only 2 to 3 mm wide ,1 to 1.5 mm thick and has an appropriate length to cover the full apical extension of the recipient site. The strip is sutured immediately with 6-0 monocryl sutures. Coronal to the strip, the periosteal bed is covered with ADM, which is already rehydrated in sterile saline for 10 min, trimmed and customized to fit the available space. The ADM is then stabilized on the periosteal bed with the epithelium side facing upward. The ADM is fixed on the recipient bed by periosteal 6-0 monocryl sutures.
Two vertical incisions are made, and a partial thickness flap are designed to provide a firm and immobile periosteal bed. The raised partial thickness flap will be excised. Muscle and unattached connective tissue fibers are thoroughly scraped with a scalpel to prevent graft mobility. Autogenous FGG was harvested with #15C scalpel blade from hard palate at the same side randomly selected to receive the FGG. Donor area will be sutured with 5-0 gut sutures. FGG, is placed and stabilized with simple interrupted 5-0 vicryl sutures at recipient site coronal border and horizontal or periosteal anchorage sutures over the graft.