Topic

[Surgery]  soft tissue grafting to gain vertical height but with Alloderm allograft


Hello Bites Mentors,

I have a healthy 65 year old female with no medical/health issues presenting with some localized areas of recession at teeth #33 and 42. There are no muscle pulls involved in either of the areas either.  She would like to have the vertical height of her soft tissue restored as best as I can in each of these areas but doe not want to deal with any harvesting surgeries.  I did discuss the possibility of using an Allograft like Alloderm in this area along with PRF.  Please provide your input as to likely outcome of this approach and the steps and techniques that you would use please.

Thanks

San


by San Bhatha at Wed, Sep 18, 2013 8:27 PM

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San Bhatha Replied at Thu, Sep 19, 2013 9:03 PM

Thank you both Albert and Mark for your input. Mark thank you for the tips and suggestions.



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Mark Kwon Replied at Thu, Sep 19, 2013 8:17 PM

Hi San, I agree with Albert. You can use commercial dermal matrix. It is an option, if pt chooses it. But nothing beats autogeneous Tissue. I dont care what Pat allen or other leading lecturers say how good the commercial product is. YES, commercial product is much better than Nothing. either way, your technique should not change. This is a combination Miller classification 1 and 3 for #33 and class 2 for #42. You should get predictable coverage but will not get 100% due to lack of bone support on distal aspect of #33. I would use Advanced pouch technique for both using sulcular knife and modified orban knife and secure the graft and ensure full flap coverage using 'sling-suture' technique. With clean technique , you should get predictable outcome even with dermal matrix in this case but healing will take longer. Do not remove goretex suture for 3 weeks. Try not to get your matrix exposed. - mark