If soft tissue is lacking after major bone augmentations, use is often made of giant autologous soft tissue transplants from the palate: either free gingival grafts or connective tissue grafts. Their removal is painful due to the creation of large wound surfaces in the palate.
Narrow transplant provides cells to the matrix
Prof. Istvan Urban, Hungary/USA, has published a prospective series of cases for an alternative method1. This involves him using only a narrow free gingival graft of about 2-3 mm in width and combining it with the Geistlich Mucograft® collagen matrix. The underlying idea: the autologous transplant, placed apically parallel to the collagen matrix, ensures that the collagen matrix is replaced by new keratinised tissue instead of by non-keratinising mucosal cells.
6.33 mm gained
After one year a mean 6.33 mm of keratinised tissue had been gained. Use of analgesics and patient-reported morbidity were very low.
Details of the case series:
Involvement: 20 patients with at least one site without keratinised tissue in conjunction with loss of vestibular depth
Primary endpoint: widening the keratinised tissue after 12 months
Secondary endpoints: transplant shrinkage, morbidity after 1 and 2 weeks (use of analgesics plus measurement using visual analogue scale)
Evaluation: 12 months after surgery
- Urban IA, et al.: Int J Periodontics Restorative Dent 2015; 35(3): 345-53.