Advisory Committee Chair
Advisory Committee Members
Maria L Geisinger
Date of Award
Degree Name by School
Master of Science (MS) School of Dentistry
Several surgical techniques have been described to increase keratinized tissue (KT) around implants and teeth. Despite various methods, the bulk of evidence reported that the use of keratinized autogenous graft (i.e., Free Gingival Grafts (FGG)), harvested from the patient’s palate, remained the gold standard in soft tissue augmentation procedures and provided more predictable results. However, soft tissue autograft supply can be limited, and its harvesting is associated by increased patient morbidity. Several clinical studies have demonstrated the effectiveness of using allogenic soft tissue grafts such as Acellular Dermal Matrix Allograft (ADMA) instead of FGG to augment keratinized tissue (KT). This case series evaluates a technique aiming to achieve a change in the tissue quality at areas with insufficient Keratinized Tissue (KT) using an autogenous soft tissue graft (Strip gingival graft (SGG)) with acellular dermal matrix allograft (ADMA). A total of eight implant sites were treated and assessed for a duration of three months, with two patients (three implant sites) followed up to the six-month evaluation appointment. Key parameters including width of keratinized tissue (WKT), plaque index (PI), gingival index (GI), probing depth (PD), recession (Rec), tissue thickness (TT1 and TT2), esthetics, and patient-centered outcomes were evaluated. At the three-month postoperative evaluation, no significant changes were observed in PD, GI, and R compared to the screening visit. However, WKT exhibited a significant gain, with an average width of 5.00 mm (SD 0.67 mm, P<0.05). Additionally, a significant increase in tissue thickness of 1.06 mm (P<0.05) was observed at 2 mm apical iv to the gingival margin (TT1). There was a 0.5 mm gain in tissue thickness at 4 mm apical to the gingival margin (TT2), although the difference was not statistically significant (P>0.05). In conclusion, the combination graft of SGG+ADM demonstrated promising results in increasing WKT. Moreover, patients reported minimal morbidity, as evidenced by low post-operative pain measured using the Visual Analogue Scale (VAS).
Haddad, Louai, "Gain of Keratinized Muscosa Around Dental Implants Using a Combination of Strip Gingival Graft and Acellular Dermal Matrix - A Prospective Case Study" (2023). All ETDs from UAB. 458.