DOCSLIB.ORG

Extracellular Matrix-Based Scaffolding Technologies for Periodontal and Peri-Implant Soft Tissue Regeneration

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Extracellular Matrix-Based Scaffolding Technologies for Periodontal and Peri-Implant Soft Tissue Regeneration Received: 15 June 2019 Revised: 3 August 2019 Accepted: 10 August 2019 DOI: 10.1002/JPER.19-0351 REVIEW Extracellular matrix-based scaffolding technologies for periodontal and peri-implant soft tissue regeneration Lorenzo Tavelli1 Michael K. McGuire1,2,3 Giovanni Zucchelli1,4 Giulio Rasperini1,5 Stephen E. Feinberg6 Hom-Lay Wang1 William V. Giannobile1,7 1Department of Periodontics & Oral Medicine, University of Michigan, School of Dentistry, Ann Arbor, MI, USA 2Private practice, Houston, TX, USA 3Department of Periodontics, University of Texas, Dental Branch Houston and Health Science Center, San Antonio, TX, USA 4Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy 5Department of Biomedical, Surgical and Dental Sciences, University of Milan, Foundation IRCCS Ca’ Granda Policlinic, Milan, Italy 6Department of Oral and Maxillofacial Surgery, University of Michigan, Ann Arbor, MI, USA 7Department of Biomedical Engineering & Biointerfaces Institute, College of Engineering, University of Michigan, Ann Arbor, MI, USA Correspondence Abstract William V.Giannobile, DDS, MS, DMSc, The present article focuses on the properties and indications of scaffold-based extra- Najjar Professor of Dentistry and Chair, cellular matrix (ECM) technologies as alternatives to autogenous soft tissue grafts Department of Periodontics and Oral Medicine, University of Michigan, School for periodontal and peri-implant plastic surgical reconstruction. The different pro- of Dentistry, 1011 North University Avenue, cessing methods for the creation of cell-free constructs resulting in preservation of Ann Arbor, MI 48109-1078, USA. Email: [email protected] the extracellular matrices influence the characteristics and behavior of scaffolding biomaterials. The aim of this review is to discuss the properties, clinical applica- tion, and limitations of ECM-based scaffold technologies in periodontal and peri- implant soft tissue augmentation when used as alternatives to autogenous soft tissue grafts. KEYWORDS acellular dermal graft, collagen matrix, dental implant, gingival recession, soft tissue augmentation, soft tissue volume 1 SCAFFOLD CONSTRUCTS FOR Ideally, biomaterials should be characterized by certain prop- SOFT TISSUE AUGMENTATION erties, including biocompatibility, ease in surgical site adap- tation and positioning, space maintenance, clot stabilization, Biomaterials have progressively gained popularity in peri- tissue integration, cell invasion/guidance, and promotion of odontics due to their advantages compared with autogenous cellular proliferation.3 Based on their origin, scaffolds can grafts, such as unrestricted availability, avoidance of a sec- be classified as allogenic, xenogeneic, alloplastic, and liv- ondary surgical site, reduction of the surgical time, and ing constructs (when they include cells). This review aims patient’s preference.1 Indeed, the risk of developing moder- to present the characteristics, clinical application, and limi- ate/severe postoperative swelling and pain increased at 3% and tations of extracellular matrix (ECM)-based technologies in 4%, respectively, for each minute of the surgical procedure.2 periodontal and peri-implant soft tissue augmentation. J Periodontol. 2020;91:17–25. wileyonlinelibrary.com/journal/jper © 2019 American Academy of Periodontology 17 18 TAVELLI ET AL. 2 NATURAL AND CADAVERIC biomechanical and biochemical properties of the allograft. It SCAFFOLDS has been suggested that several properties should be consid- ered when choosing the graft, including tissue origin, process- 2.1 Decellularized human dermis ing methods, cross-linking, and biomechanical properties,25 and that the different procedures to obtain human allografts Acellular dermal matrix (ADM) is a soft tissue graft obtained may influence scaffold characteristics, such as cell penetration from human skin that has undergone a decellularization and proliferation.26,27 Kuo et al. compared AlloDerm with process.4,5 Devoid of epithelium and cellular components, Allopatch as scaffolds supporting cellular ingrowth in fabri- the preserved ECM serves as a scaffold that promotes cellu- cating tissue-engineered grafts (TEGs).27 They observed dif- lar migration and revascularization from the surrounding host ferent properties between the allografts, suggesting that decel- tissues.4–7 lularization protocols can affect the scaffold’s biological and First introduced for the treatment of burn wounds,8 the physical characteristics.27 Increased vascular invasion into the ADM has been extensively used in several other indications, constructs were found for TEGs based on Allopatch compared such as facial augmentation, dural replacement, breast recon- with those including AlloDerm. However, AlloDerm-based struction, and esthetic plastic surgery.4,9,10 In dentistry, ADM TEGs showed more rapid cellular migration.27 was firstly evaluated for increasing attached and/or kera- tinized gingivae.11 However, the ADM clinical outcomes are inferior to the free gingival graft (FGG).12,13 In particular, 2.2 Human amniotic membrane the ADM seems to be more prone to shrinkage, which may Human amniotic membrane (HAM) is the innermost fetal also explain the reduced tissue thickness observed.5,13 His- membrane lining the amniotic cavity (0.02 to 0.05 mm in tological data of sites treated with ADM show a “scar” tissue thickness), which is derived from healthy maternal donors appearance,6 although better esthetic and color match with the during an elective caesarian section.28 All donors’ serum surrounding tissue has been described, when compared with samples are tested to ensure the absence of viruses and all a FGG.5,6,13 serologic tests are also repeated 6 months later.29 HAM Currently, the ADM is more routinely used for root cover- undergoes a process of preparation and preservation, such as age procedures (Fig. 1) and soft tissue augmentation at tooth cryopreservation and glycerol preservation or lyophilization or implant sites (Fig. 2),14–19 particularly when avoiding and gamma irradiation,30 resulting in the elimination of the a second surgical site and minimizing patient morbidity is cellular component while preserving the matrix.31,32 HAM is the primary concern.17,20,21 Although ADM is considered composed by a single epithelial layer, a thick basement mem- to be the graft substitute with the most similar outcomes to brane, and an avascular collagen layer.28,30 The avascular the connective tissue graft (CTG),22 a recent network meta- stroma contains several growth factors, including epidermal analysis evaluating the changes in root coverage outcomes growth factor, transforming growth factors alpha and beta over time showed that only CTG-treated sites had a trend (TGF-,TGF-), fibroblast growth factor-2, and keratinocyte towards the stability of the gingival margin among the other growth factor.29,33 These growth factors contribute to the root coverage techniques.19 Similarly, a 12-year follow-up anti-inflammatory, immunomodulatory, antimicrobial, study reported a significant relapse of the gingival margin in antiviral, anti-scarring, and analgesic properties.28,30,34,35 In multiple gingival recessions treated with ADM.17 A possible addition, it has been reported that HAM promotes epithelial mechanism may be that the ADM may not have the capability wound healing, angiogenesis, and ECM deposition.28,30,34,35 of inducing keratinization of the overlying epithelia,5,7,13 Because of these properties, HAM has been used in several which seems to be a positive predictor for the stability of fields for the promotion of wound repair and regeneration.30,36 the gingival margin.17,19,23,24 It can be suggested that with In periodontics, it has been investigated for application in the treatment of ADM, similar root coverage outcomes to guided tissue regeneration36 and in the treatment of gingival CTG can be obtained in the presence of a distinct amount of recession.28 In a randomized controlled study, it was con- keratinized tissue width at baseline (≥2mm17). firmed that cryopreserved amniotic membrane was effective Various human-derived ADMs are currently available, in enhancing cicatrization, wound healing, and reducing pain ∗ † ‡ including AlloDerm, Puros Dermis, and Allopatch . in patients undergoing implant placement.29 Disadvantages Allopatch is derived from the human fascia lata from the of this allograft includes difficulty in handling, rapid degra- American Association of Tissue Banks. This allograft dation, and the lack of adherence in full-thickness burns is minimally processed, which may better preserve the where HAM acts as a temporary wound dressing.37 HAM is commercially available as BioXclude.§ ∗ BioHorizons, Birmingham, AL. † Zimmer Dental, Carlsbad, CA. ‡ Musculoskeletal Transplant Foundation, Edison, NJ. § Snoasis Medical, Golden, CO. TAVELLI ET AL. 19 FIGURE 1 A through F) Coronally advanced flap and acellular dermal matrix for the treatment of an isolated gingival recession. A) Preoperative gingival recession on the left maxillary canine; B) flap design and elevation; C) acellular dermal matrix adapted and sutured over the root; D) flap coronally advanced and sutured; E) 6 month result; F) the complete root coverage is maintained also at the 10-year recall. G through L) Tunnel technique and acellular dermal matrix used for the treatment of multiple adjacent gingival recessions. G) clinical scenario at baseline; H) tunnel flap is performed; I) acellular dermal matrix is inserted in the flap; J) the flap is sutured together with
Load more

Recommended publications
  • Download Article (PDF)
    Advances in Health Science Research, volume 8 International Dental Conference of Sumatera Utara 2017 (IDCSU 2017) Black Triangle, Etiology and Treatment Approaches: Literature Review Putri Masraini Lubis Rini Octavia Nasution Resident Lecturer Department of Periodontology Department of Periodontology Faculty of Dentistry, University of Sumatera Utara Faculty of Dentistry, University of Sumatera Utara [email protected] Zulkarnain Lecturer Department of Periodontology Faculty of Dentistry, University of Sumatera Utara Abstract–Currently, beauty and physical appearance is Loss of the interdental papillae results in a condition of a major concern for many people, along with the known as the black triangle. Various factors may affect greater demands of aesthetics in the field of dentistry. in the case of interdental papilla loss, including alveolar Aesthetics of the gingival is one of the most important crest height, interproximal spacing, soft tissue, buccal factors in the success of restorative dental care. The loss of thickness, and extent of contact areas. With the current the interdental papillae results in a condition known as the black triangle. Interdental papilla is one of the most adult population which mostly has periodontal important factors that clinicians should pay attention to, abnormalities, open gingival embrasures are a common especially in terms of aesthetic. The Black triangle can thing. Open gingival embrasures also known as black cause major complaints by the patients such as: aesthetic triangles occur in more than one-third of the adult problems, phonetic problems, food impaction, oral population; black triangle is a state of disappearance of hygiene maintenance problems. The etiology of black the interdental papillae and is a disorder that should be triangle is multi factorial, including loss of periodontal discussed first with the patient before starting treatment.
    [Show full text]
  • The Consumer's Guide to Safe, Anxiety-Free Dental Surgery
    The Consumer’s Guide to Safe, Anxiety-Free Dental Surgery Jeffrey V. Anzalone, DDS 1 2 About The Author 7 Meet The Anzalones 9 Acknowledgments 11 Overview of the BIG PICTURE 13 The 9 Most Important Dental Surgery Secrets 13 Chapter 2 Selecting the Right Dental Surgeon 17 What Are the Dental Specialties That Perform Surgery? 19 What Is a Periodontist? 20 Chapter 3 The Consultation 23 The Initial Consultation: Examining the Doctor 25 Am I a candidate for surgery? 26 14 Questions to Ask Your Prospective Periodontist 27 Chapter 4 Gum Disease (Periodontitis) 29 Gum Disease Symptoms 30 Pocket Recording 32 Is gum disease contagious? 32 Gum Disease and the Human Body 33 Gum Disease and Cardiovascular Disease 33 Gum Disease and Other Systemic Diseases 34 Gum Disease and Women 35 Gum Disease and Children 37 Signs of Periodontal Disease 38 Advice for Parents 39 Gum Disease Risk Factors 41 Non-Surgical Periodontal Treatment 42 Regenerative Procedures 43 Pocket Reduction Procedures 44 Follow-Up Care 45 Chapter 5 The Photo Gallery 47 Free Gingival Graft 47 Connective Tissue Graft 49 Dental Implants 51 Sinus Lift With Dental Implant Placement 53 Classification of Implant Sites 53 Implants placed after sinus has been elevated 54 3 4 Sinus Lift as a Separate Procedure 55 Sinus Perforation 55 Bone Grafting 57 Esthetic Crown Lengthening 59 Crown Lengthening for a Restoration 60 Tooth Extraction and Socket Grafting 61 More Photos of Procedures 62 Connective Tissue Graft 62 Connective Tissue Graft + Crowns 64 Free Gingival Graft 64 Esthetic Crown Lengthening
    [Show full text]
  • Free Gingival Autograft for Augmen- Tation of Keratinized Tissue and Stabili- Zation of Gingival Recessions
    Journal of IMAB - Annual Proceeding (Scientific Papers) 2008, book 2 FREE GINGIVAL AUTOGRAFT FOR AUGMEN- TATION OF KERATINIZED TISSUE AND STABILI- ZATION OF GINGIVAL RECESSIONS Chr. Popova, Tsv. Boyarova Department of Periodontology Faculty of Dental Medicine, Medical University - Sofia, Bulgaria SUMMARY: formation and periodontal disease can cause progressive Background: The presence of gingival recession loss of attachment and displacement of gingival margin associated with an insufficient amount of keratinized tissue apically reducing vestibular depth. Proper oral hygiene is may indicate gingival augmentation procedure. The most impossible in such cases with minimal vestibular depth and common technique for gingival augmentation procedure is lack of attached gingiva (2, 15). the free gingival autograft. There are several evidences that persons who The aim of this study was to evaluate the changes practice optimal oral hygiene may maintain periodontal in the amount of keratinized tissue and in the position of health with minimal amount of keratinized gingiva (18). gingival margin in sites treated with free gingival autograft However, a number of authors suggest that sufficient apical to the area of Miller’s class I, class II and class III amount of keratinized tissue is considered essential to gingival recessions. preserve the healthy periodontal status and to support the Methods: Twenty three subjects with 56 gingival dentogingival unit more resistant during the masticatory recessions associated with an insufficient amount of function and oral hygiene procedure (9). Therefore the keratinized gingiva were treated with gingival augmentation presence of gingival recession associated with a minimal procedure (free gingival graft). The grafts were positioned amount or lack of keratinized gingiva may indicate need of apical to the area of recession at the level of mucogingival gingival augmentation procedure to prevent additional junction.
    [Show full text]
  • Free Gingival Graft As a Single Step Procedure for Treatment of Mandibular Miller Class I and II Recession Defects
    12 Gingival graft in mandibular defect Original Article Free Gingival Graft as a Single Step Procedure for Treatment of Mandibular Miller Class I and II Recession Defects Lata Goyal1*, Narender Dev Gupta2, Namita Gupta2, Kirti Chawla3 1. Department of Dentistry, All India ABSTRACT Institute of Medical Sciences, Rishikesh, India; BACKGROUND 2. Department of Periodontics and Gingival recession is a frequent issue encountered by both Community Dentistry, Dr. Ziauddin Ahmad Dental College, Aligarh Muslim the clinician and the patient. This study was aimed to University, Aligarh India; assess the predictability of the free gingival graft as a single 3. Department of Periodontology, Jamia Millia Islamia, New Delhi, India step procedure in terms of root coverage and aesthetics in Miller Class I and II mandibular gingival recession. METHODS Ten patients (4 males, 6 females) aged 25-30 years with a total of 12 mandibular sites having Miller class I and II recession were selected. All recession sites were treated with single step free gingival graft procedure. Clinical parameters like recession depth, recession width, width of attached gingiva, probing depth and clinical attachment level were recorded at baseline, 6 and 9 months. Visual analog score at 1, 6 and 9 months postoperatively was provided. RESULTS There was a reduction in mean recession depth from 3.66±1.20 to 0.91±0.99 mm suggesting coverage of 82% over a period of 9 months. There was statistically significant gain in clinical attachment level and width of attached gingiva. Aesthetically, it was acceptable by patients as measured by visual analog scores. CONCLUSION Free gingival graft as a single step procedure is acceptable in terms of root coverage and aesthetics.
    [Show full text]
  • Treatment Concepts for Soft Tissue Regeneration with Geistlich Mucograft
    Treatment concepts for soft tissue regeneration with Geistlich Mucograft® 600526/1907/en © 2017 Geistlich Pharma AG – Subject to modifi cations – Subject to modifi © 2017 Geistlich Pharma AG 600526/1907/en Acknowledgements Geistlich Biomaterials is grateful to Dr. D. S. Thoma, PD Dr. R.E. Jung, Dr. Prof. Dr. mult. R. A. Sader, Dr. S. Ghanaati, Dr. I. Zabalegui, Dr. M. K. McGuire, Dr. R. Abundo, and Dr. G. Corrente for kindly sup- plying the images used in this brochure. We acknowledge the authors of the clinical cases and the participants of the Geistlich Mucograft® Seal Advisory Board Meeting for their valuable contribution and eff orts: Dr. A. Guerrero, Prof. Dr. M. Sanz, Dr. R. Lorenzo, Dr. D. Panaite, Dr. A. Charles, Dr. E. Vaia, Dr. U. Konter, Dr. H. Antoun, PD Dr. R.E. Jung, Dr. M. K. McGuire, Dr. E. T. Scheyer, Dr. D. Cardarop- oli, Prof. Dr. G. Zucchelli, Dr. P. Lindkvist, Dr. H. De Vree, Prof. Dr. H. De Bruyn, Dr. C. Romagna, Dr. O. Brendel, Dr. S. Aroca, Prof. Dr. A. Sculean, Dr. I. Sanz, PD Dr. S. Fickl, Dr. B. Wallkamm, Dr. A. Laskus, Dr. J. Sola, Dr. L. Ramaglia, Dr. R. Cavalcanti, PD Dr. D.S. Thoma, Dr. M. Bechtold, Prof. Dr. N. Donos. Geistlich Biomaterials thanks ACME Publishing for the copyright permission. Why are soft tissue graft alternatives needed? In recent years there has been a change in the direction of the treatment concept for edentulous patients towards an increasing awareness of the significance of dental aesthetics. Although bone is the supporting framework, the quantity and quality of the soft tissue around teeth and implants gain progressively in importance.
    [Show full text]
  • Soft Tissue Reconstruction with Free Gingival Graft Technique Following Excision of a Fibroma
    Hindawi Publishing Corporation Case Reports in Dentistry Volume 2015, Article ID 248363, 4 pages http://dx.doi.org/10.1155/2015/248363 Case Report Soft Tissue Reconstruction with Free Gingival Graft Technique following Excision of a Fibroma Nurcan Tezci,1 Suleyman Emre Meseli,1 Burcu Karaduman,1 Serap Dogan,2 and Sabri Hasan Meric1 1 Department of Periodontology, Faculty of Dentistry, Istanbul Aydin University, 34295 Istanbul, Turkey 2Department of Pathology, Faculty of Medicine, Istanbul University, 34093 Istanbul, Turkey Correspondence should be addressed to Suleyman Emre Meseli; [email protected] Received 25 June 2015; Revised 7 August 2015; Accepted 13 August 2015 Academic Editor: Adriano Loyola Copyright © 2015 Nurcan Tezci et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background. Oral fibromas are benign, asymptomatic, smooth surfaced, firm structured tumoral lesions that originate from gingival connective tissue or periodontal ligament. Histologically, they are nodular masses characterized by a dense connective tissue, surrounded by stratified squamous epithelium. Case Report. This case report includes the clinical, radiographical, and histological findings and periodontal treatment of a 38-year-old female patient having painless swelling on the gingiva. Intraoral examination revealed a fibrotic, sessile, smooth surfaced gingival overgrowth interdentally between the teeth #13 and #14. Radiographical findings were normal. Initial periodontal treatment (IPT) was applied including oral hygiene instructions, scaling, and root planing. Following IPT, the lesion (0.7 × 0.6 × 0.4 cm) was excised and examined histopathologically. Subsequently, flap operation was performed to have an access to alveolar bone.
    [Show full text]
  • TO GRAFT OR NOT to GRAFT? an UPDATE on GINGIVAL GRAFTING DIAGNOSIS and TREATMENT MODALITIES Richard J
    October 2018 Gingival Recession Autogenous Soft Tissue Grafting Tissue Engineering JournaCALIFORNIA DENTAL ASSOCIATION TO GRAFT OR NOT TO GRAFT? AN UPDATE ON GINGIVAL GRAFTING DIAGNOSIS AND TREATMENT MODALITIES Richard J. Nagy, DDS Ready to save 20%? Let’s go! Discover The Dentists Supply Company’s online shopping experience that delivers CDA members the supplies they need at discounts that make a difference. Price compare and save at tdsc.com. Price comparisons are made to the manufacturer’s list price. Actual savings on tdsc.com will vary on a product-by-product basis. Oct. 2018 CDA JOURNAL, VOL 46, Nº10 DEPARTMENTS 605 The Editor/Nothing but the Tooth 607 Letter to the Editor 609 Impressions 663 RM Matters/Are Your Patients Who They Say They Are? Preventing Medical Identity Theft 667 Regulatory Compliance/OSHA Regulations: Fire Extinguishers, Eyewash, Exit Signs 609 674 Tech Trends FEATURES 615 To Graft or Not To Graft? An Update on Gingival Grafting Diagnosis and Treatment Modalities An introduction to the issue. Richard J. Nagy, DDS 617 Gingival Recession: What Is It All About? This article reviews factors that enhance the risk for gingival recession, describes at what stage interceptive treatment should be recommended and expected outcomes. Debra S. Finney, DDS, MS, and Richard T. Kao, DDS, PhD 625 Autogenous Soft Tissue Grafting for the Treatment of Gingival Recession This article reviews the use of autogenous soft tissue grafting for root coverage. Advantages and disadvantages of techniques are discussed. Case types provide indications for selection and treatment. Elissa Green, DMD; Soma Esmailian Lari, DMD; and Perry R.
    [Show full text]
  • Free Gingival Grafts: a Histological Evaluation in Humans
    Loyola University Chicago Loyola eCommons Master's Theses Theses and Dissertations 1970 Free Gingival Grafts: A Histological Evaluation in Humans Robert Cannon Bracket Loyola University Chicago Follow this and additional works at: https://ecommons.luc.edu/luc_theses Part of the Dentistry Commons Recommended Citation Bracket, Robert Cannon, "Free Gingival Grafts: A Histological Evaluation in Humans" (1970). Master's Theses. 2432. https://ecommons.luc.edu/luc_theses/2432 This Thesis is brought to you for free and open access by the Theses and Dissertations at Loyola eCommons. It has been accepted for inclusion in Master's Theses by an authorized administrator of Loyola eCommons. For more information, please contact [email protected]. This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License. Copyright © Robert Cannon Bracket FREE GINGIV AL GRAFTS: A HISTOLOGICAL BV ALUA TION IN HUMANS BY Robert Cannon Brackett. o. o. s. A THESIS SUBMITIBO TO nlB FACULTY OF THE GRADUATE SCHOOL OP LOYOLA UNIVERSITY IN PARTIAL FULFILLMENT OP THE REQUIREMENTS OP THE DBGRBB OF MASTER OF SCIENCE. May, 1970 t: :, Rt,~;2.. ~f LOYOLA UNIVERSitY MEDICAL CENTER AUTOBIOGRAPHY The author was born on July 16, 1939 in Fort Worth, Texas. A rather nomadic life makes the schools attended for primary education too numerous to mention here. His public education was completed in 1957 at Lubbock Senior High, Lubbock, Texas. Athletics were limited to football and boxing. After completing one semester attending Texas Techno­ logical College, he volunteered for the draft. He was inducted into the Army and while ftniahing a European tour, decided on dentistry as ht• future course d.
    [Show full text]
  • Soft Tissue Reconstruction with Free Gingival Graft Technique Following Excision of a Fibroma
    Hindawi Publishing Corporation Case Reports in Dentistry Volume 2015, Article ID 248363, 4 pages http://dx.doi.org/10.1155/2015/248363 Case Report Soft Tissue Reconstruction with Free Gingival Graft Technique following Excision of a Fibroma Nurcan Tezci,1 Suleyman Emre Meseli,1 Burcu Karaduman,1 Serap Dogan,2 and Sabri Hasan Meric1 1 Department of Periodontology, Faculty of Dentistry, Istanbul Aydin University, 34295 Istanbul, Turkey 2Department of Pathology, Faculty of Medicine, Istanbul University, 34093 Istanbul, Turkey Correspondence should be addressed to Suleyman Emre Meseli; [email protected] Received 25 June 2015; Revised 7 August 2015; Accepted 13 August 2015 Academic Editor: Adriano Loyola Copyright © 2015 Nurcan Tezci et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background. Oral fibromas are benign, asymptomatic, smooth surfaced, firm structured tumoral lesions that originate from gingival connective tissue or periodontal ligament. Histologically, they are nodular masses characterized by a dense connective tissue, surrounded by stratified squamous epithelium. Case Report. This case report includes the clinical, radiographical, and histological findings and periodontal treatment of a 38-year-old female patient having painless swelling on the gingiva. Intraoral examination revealed a fibrotic, sessile, smooth surfaced gingival overgrowth interdentally between the teeth #13 and #14. Radiographical findings were normal. Initial periodontal treatment (IPT) was applied including oral hygiene instructions, scaling, and root planing. Following IPT, the lesion (0.7 × 0.6 × 0.4 cm) was excised and examined histopathologically. Subsequently, flap operation was performed to have an access to alveolar bone.
    [Show full text]
  • Redalyc.Aesthetic Improvements in Free Gingival Graft Due to Its
    RSBO Revista Sul-Brasileira de Odontologia ISSN: 1806-7727 [email protected] Universidade da Região de Joinville Brasil Lopes, Tertuliano Ricardo; Machado, Cassiana Nathalie; Camargo Rogacheski, Mariana; Verbicaro, Thalyta; Giovanini, Allan Fernando; Miranda Deliberador, Tatiana Aesthetic improvements in free gingival graft due to its association with frenectomy RSBO Revista Sul-Brasileira de Odontologia, vol. 10, núm. 2, abril-junio, 2013, pp. 135-142 Universidade da Região de Joinville Joinville, Brasil Available in: http://www.redalyc.org/articulo.oa?id=153027495006 How to cite Complete issue Scientific Information System More information about this article Network of Scientific Journals from Latin America, the Caribbean, Spain and Portugal Journal's homepage in redalyc.org Non-profit academic project, developed under the open access initiative ISSN: Electronic version: 1984-5685 RSBO. 2013 Apr-Jun;10(2):135-42 Original Research Article Aesthetic improvements in free gingival graft due to its association with frenectomy Tertuliano Ricardo Lopes1 Cassiana Nathalie Machado1 Mariana Camargo Rogacheski1 Thalyta Verbicaro1 Allan Fernando Giovanini1 Tatiana Miranda Deliberador1 Corresponding author: Tatiana Miranda Deliberador Mestrado Profissional em Odontologia Clínica, Universidade Positivo Rua Professor Pedro Viriato Parigot de Souza, n. 5.300 – Campo Comprido CEP 81280-330 – Curitiba – PR – Brasil E-mail: [email protected] 1 Department of Dentistry, Positivo University – Curitiba – PR – Brazil. Received for publication: November 11, 2012. Accepted for publication: December 1, 2012. Abstract Keywords: Introduction: The insufficient amount of attached gingiva and the Periodontics; labial abnormal insertion of the labial frenulum may be related. When this frenulum; gingiva; occurs, it is common to associate frenectomy techniques with free histology; clinical gingival graft (FGG).
    [Show full text]
  • Alloplastic Bone Grafting System
    WESTERN SOCIETY OF PERIODONTOLOGY “Synergy For Success: Innovations in Periodontology” 66TH ANNUAL SCIENTIFIC SESSION San Diego 2018 THE COLLABORATIVE EVENT OF THE YEAR! PERIODONTOLOGY • RESTORATIVE • HYGIENE NEW FOR 2018 Improved Schedules More CE Courses Corporate Forums Manchester Grand Hyatt, San Diego HOTEL APRIL 6 - 8 PROGRAM • FRANK SCHWARTZ, PROF. DR. MED. DENT. • DHAVAL PATEL, DDS - Clinical Excellence with In-Office CadCam Treatment Concepts For The Management Of Peri-Implantitis *Hands-On: Soft-Tissue Augmentation and Corrections for the • BEN MIRAGLIA, DDS - Better Periodontal Health with Clear Aligner Therapy Prevention and Management of Peri-Implant Diseases • BOBBY BIRDI, DMD, MS - Surgical-Prosthetic Synergy in Today’s Implant Treatment • DENNIS TARNOW, DDS • GEORGIOS E. ROMANOS, DDS, PHD, PROF. DR. MED. DENT. Interdisciplinary Approach To Difficult Aesthetic Cases Implant Diameter as a Key for Long-Term Success in Implant Dentistry • RODRIGO NEIVA, DDS, MS • BALDWIN MARCHACK, DDS, MBA Current Trends in Periodontics and Implant Dentistry Esthetics & Implant Prosthetics: Avoiding Failures And Complications • STANLEY MALAMED, DDS • SANDA MOLDOVAN, DDS 10 Minutes to Save a Life: Emergency Medicine in Dentistry Increase the success of your dental implant practice with your hygiene protocol • SALAH HUWAIS, DDS • DIANE MILLAR, RDH, MA *Hands-On: Osseodensification: Optimize the Site-Optimize the Outcome State of the Art Hygiene: A Virtual Reality Trip Through Cutting Edge Scaling Techniques • EARNEST CHOLAKIS, DMD, MBA *Hands-On:
    [Show full text]
  • Use of Mucograft Collagen Matrix® Versus Free Gingival Graft to Augment Keratinized Tissue Around Teeth: a Randomized Controlled Clinical Trial
    Frontiers in Dentistry Use of Mucograft Collagen Matrix® versus Free Gingival Graft to Augment Keratinized Tissue Around Teeth: A Randomized Controlled Clinical Trial Amirreza Rokn1,2, Hadi Zare3, Pardis Haddadi3* 1. Dental Implant Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran 2. Department of Periodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran 3. Department of Periodontics, Faculty of Dentistry, Lorestan University of Medical Sciences, Khorramabad, Iran Article Info A B S T R A C T Article type: Objectives: This study aimed to evaluate the mucograft collagen matrix (CM) to Original Article increase keratinized tissue around teeth compared to free gingival graft (FGG). Materials and Methods: The present double-blind, randomized, controlled clinical trial studied 12 patients who had 2 mm or less keratinized gingiva bilaterally around mandibular premolars. The 6-month width of keratinized tissue, periodontal Article History: parameters (preoperatively and 1, 3, and 6 months postoperatively), color match, Received: 16 Jul 2019 pain, and total surgical time were measured. Accepted: 17 Dec 2019 Published: 8 Mar 2020 Results: The mean dimensional change of keratinized gingiva 6 months postoperatively was 4.1±0.7 mm for FGG and 8±1.7 mm for CM. Periodontal parameters were not affected in the two groups. The CM group had a significantly lower pain, experienced less surgery time, and gained better aesthetics compared to * Corresponding author: the FGG group. Department of Periodontics, Faculty of Dentistry, Lorestan University of Medical Conclusion: CM appears to be a suitable substitute for FGG in procedures designed Sciences, Khorramabad, Iran to increase keratinized tissue around teeth.
    [Show full text]