Dental connective tissue grafting

STATEMENT OF PROBLEM: Immediate placement and provisionalization of implants in fresh sockets has been previously demonstrated to be a predictable treatment in the restoration of non-recoverable teeth in the anterior regions of the maxilla. PURPOSE: This article reports a clinical case in which an immediate implant placement protocol was used in combination with two distinct and sequential grafts (bovine bone and connective tissue, respectively) followed by immediate implant provisionalization using the patient's crown of an extracted tooth...

Achieving symmetry of the soft-tissue margins between anterior maxillary dental-implant restorations and adjacent teeth is a therapeutic challenge for both the implant surgeon and the restorative dentist. This article describes a modified procedure utilizing autogenous connective-tissue grafts to improve primarily buccal soft-tissue margins and secondarily inter-proximal tissues around tooth-bound single dental implants. This technique has the advantage of allowing for coronal augmentation of the peri-implant soft tissue while maximizing the blood supply to the area by using tunneling-technique principles...

New and innovative surgical techniques are necessary to help the clinician ensure the best results and satisfy patient's expectations. One such periodontal problem that has been challenging to the dental practitioners and impacts the oral health quality of life of patients has been gingival recession. When present anteriorly where esthetics is a major concern, patient centric parameters too become paramount. Root coverage esthetic score (RES) evaluation helps to keep the patient outcomes in mind. This case reports the successful treatment of a wide anterior mucogingival defect using epithelial embossed connective tissue graft which was evaluated for the first time using RES...

Objectives: The present paper reports data of a randomized study aimed to analyse and compare the histologic and histomorphometric aspects of bone healing in extraction sites covered with collagen membrane alone or associated with porcine-derived bone graft. Material and Methods: Thirty patients, with single extraction sockets without severe bone wall defects in the premolar/molar region, were included. Ten extraction sockets were grafted with porcine-derived bone and covered with collagen membrane (group 1), 10 sites were covered with collagen membrane alone (group 2), and 10 sites healed spontaneously (group 3)...

Osteogenesis Imperfecta (OI) is a rare autosomal dominant connective tissue disorder in wich, the bone quality and density is affected. OI includes some metabolic disorders and have a wide range of clinical presentations. In Osteogenesis Imperfecta bone has a very low density and it is a disorder currently treated with bisphosphonates. Quality and quantity of bone is important for establishment of osseointegration in dental implants. There are few reported cases in the literature. This is a case report of a 61 year-old man with grade IV OI, rehabilitated with implant-supported fixed prostheses in the posterior right and left mandible, whithout bone grafts...

The use of methamphetamines is a significant public health concern not only in America but worldwide. The consequences of this drug's use are widespread, having major physiologic and psychological effects that are damaging to users' bodies and well-being. Meth use wreaks havoc on one's oral health, with the effects including demineralization of tooth surfaces, carious lesions, inflammation of the periodontium, and more. In addition to examining the neurotoxic effects that methamphetamines have on the brain, this article will discuss how dental professionals can approach treatment of individuals who are affected by this debilitating drug, utilizing a strategy that combines caries arrest with oral hygiene improvement and disease prevention...

Subepithelial connective tissue grafts (SCTGs) have been extensively used to augment soft-tissue volume on dental implants and natural teeth. The authors present a technique called the controlled palatal harvest (CPH) to obtain SCTGs. CPH provides an alternative to the trap-door and single-incision techniques currently utilized. The objective of this article is to describe this harvesting technique for SCTGs. A case report is presented in which the CPH technique was successfully used to obtain a SCTG. Contrary to current techniques where the SCTG is usually taken from the palatal (bone) side, this technique involves the dissection of a thick split-thickness flap in which the graft is harvested from the raised flap...

Serum albumin has been identified as an endogenous protein that is integral to early bone regeneration. We hypothesized that albumin addition to allografts may result in better bone remodeling than what can be achieved with anorganic xenografts. Sinus elevations were performed at 32 sites of 18 patients with the lateral window technique. Sites either received filling with an anorganic bovine bone mineral (ABBM, BioOss, Geistlich, CH) or albumin impregnated allograft (BoneAlbumin, OrthoSera, AT). After 6-months patients received dental implants and 16 bone core biopsy samples were obtained from the ABBM filled, and 16 from the BoneAlbumin augmented sites...

AIM: To compare the soft tissue volume gain (VG) around single tooth implants with subepithelial connective tissue graft (SCTG) from either the lateral palate (LP) or from the tuberosity area (TA). METHODS: Thirty-two patients with 36 implants with buccal volume deficiencies were randomly assigned to receive SCTG from LP (control group/CG) or TA (test group/TG). Clinical parameters were recorded. VG was evaluated by stereolithography (STL) image superimposition of two intraoral scans (baseline/BL and 3 months after surgery/FU-3)...

The field of periodontics has become increasingly discussed and advanced in recent decades. The techniques of periodontal soft tissue grafts are among these advancements. The techniques have been used more and more clinically not only in periodontics, but also in the areas of dental implantology, aesthetics, and orthodontics. In this article, we discuss the clinical indications and the advantages and disadvantages of several autogenous tissue grafts (e.g. pedical grafts, free gingival graft, and subepithelial connective tissue graft)...

Interest has recently developed in the purposeful retention of root fragments with their periodontal apparatus to support bone and soft tissue at immediate implant sites in the esthetic zone. This methodology is designed to avoid bone grafting, connective tissue grafts, and the use of membranes and may have short-term benefits in terms of tissue preservation. However, it is not completely without long-term risks. At times, implants may be unintentionally placed into edentulous sites where root fragments remain...

INTRODUCTION: Osteosarcoma is an aggressive primary bone tumor composed of connective tissue cells directly producing osteoid and bone. Prosthetic rehabilitations in post-oncological patients after bone reconstruction are not substantially different than those of patients affected by severe atrophy of upper or lower jaw after bone reconstruction. The treatment for patients with a malignant neoplasia of the oral cavity requires multidisciplinary approach by a team of different specialists that follow the patient through the phases of diagnosis, therapy and oral rehabilitation...

BACKGROUND: Maturation of the grafted volume after lateral sinus elevation is crucial for the long-term survival of dental implants. PURPOSE: To compare endo-sinus histomorphometric bone formation between the solo- and two-window maxillary sinus augmentation techniques with or without membrane coverage for the rehabilitation of multiple missing posterior teeth. MATERIALS AND METHODS: Patients with severely atrophic posterior maxillae were randomized to receive lateral sinus floor elevation via the solo-window technique with membrane coverage (Control Group) or the two-window technique without coverage (Test Group)...

OBJECTIVES: The objective of this study was to test whether or not soft tissue augmentation with a volume-stable collagen matrix (VCMX) leads to similar volume gain around dental implants compared to autogenous subepithelial connective tissue graft (SCTG). MATERIALS AND METHODS: In 12 adult beagle dogs, immediate implants were placed with simultaneous guided bone regeneration. After 25-45 weeks, soft tissue augmentation was randomly performed using VCMX, SCTG, or a sham-operated control...

Connective tissue grafting is a means of developing stable and natural-looking soft-tissue architecture. The use of a subepithelial connective tissue graft (SCTG) has been successful in achieving root coverage and augmenting tissue thickness. Tunnel techniques enable root coverage with results that appear natural. These techniques can be applied to the treatment of dental implants with gingival recession. The purpose of this article is to demonstrate the use of a SCTG and a lateral access pouch in the treatment of multiple gingival recession defects affecting adjacent implants...

A customized treatment plan is important to reach results that will satisfy the patient providing esthetics, function, and long-term stability. This type of oral rehabilitation requires professionals from different dental specialties where communication is a major key point. Digital Smile Design allows the practitioners to plan and discuss the patient's condition to establish the proper treatment plan, which must be driven by the desired zenith position. The ideal gingival position will guide the professionals and determine the need to perform surgical procedures or orthodontic movement before placing the final restorations...

Tooth loss promotes bone and gingival tissue remodeling, thus breaking the harmony between the residual ridge and natural teeth. This is critical in the anterior region of the mouth, and the integration of several dental specialties is often essential to successful rehabilitation with implants. This article describes a multidisciplinary approach to implant-supported oral rehabilitation in the maxillary anterior region, presenting a new technique for optimizing esthetics in implants. A 19-year-old woman was missing her central and lateral incisors and had 2 dental implants in the lateral incisor sites...

BACKGROUND: The soft tissue healing and quality around dental implant is a current debated topic in the recent literature. The free gingival margin and the quantity and quality of the mucosa around teeth and surrounding dental implants still determine the hard and soft tissue healing status. OBJECTIVE: The aim of this study is to assess inter and intra-operative measurement concordance of a method aimed at evaluating the apico-coronal migration of free gingival margin, using intra-oral photography...

AIM: The aim of this study was to determine the treatment outcome of the use of a porcine monolayer collagen matrix (mCM) to augment peri-implant soft tissue in conjunction with immediate implant placement as an alternative to patient's own connective tissue. MATERIALS AND METHODS: A total of 27 implants were placed immediately in 27 patients (14 males and 13 females, with a mean age of 52.2 years) with simultaneous augmentation of the soft tissue by the use of a mCM...

Survival of dental implants depends on several factors; soft tissue (ST) management around dental implants is one of the foremost. Several studies have suggested techniques for ST management around dental implants, but none of them has discussed a suitable timetable for this process. This study aimed to review published articles related to the timing of ST management around dental implants and suggest a customized treatment protocol. A search of the PubMed database was conducted; the search was limited to English-language articles published from January 1995 to July 2015 with available full texts...