Skip to main content

Options to avoid the second surgical site: a review of literature

Abstract

As esthetics gain importance, periodontal plastic surgical procedures involving soft tissue grafts are becoming commoner both around natural teeth as well as around implants. Periodontal soft tissue grafts are primarily used for the purpose of root coverage and in pre-prosthetic surgery to thicken a gingival site or to improve the crestal volume. Soft tissue grafts are usually harvested from the palate. Periodontal plastic surgical procedures involving soft tissue grafts harvested from the palate have two surgical sites; a recipient site and another donor site. Many patients are apprehensive about the soft tissue graft procedures, especially the creation of the second/donor surgical site in the palate. In the past decade, newer techniques and products have emerged which provide an option for the periodontist/patient to avoid the second surgical site. MucoMatrixX, Alloderm®, Platelet rich fibrin, Puros® Dermis and Mucograft® are the various options available to the practicing periodontist to avoid the second surgical site. Use of these soft tissue allografts in an apprehensive patient would decrease patient morbidity and increase patient’s acceptance towards periodontal plastic surgical procedures.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9
Fig. 10
Fig. 11
Fig. 12
Fig. 13
Fig. 14
Fig. 15
Fig. 16

References

  1. Anilkumar K, Geetha A, Umasudhakar TR, Vijayalakshmi R, Pameela E (2009) Platelet-rich-fibrin: a novel root coverage approach. J Indian Soc Periodontol 13(1):50–54

    CAS  PubMed Central  Article  PubMed  Google Scholar 

  2. Aroca S, Keglevich T, Barbieri B, Gera I, Etienne D (2009) Clinical evaluation of a modified coronally advanced flap alone or in combination with a platelet-rich fibrin membrane for the treatment of adjacent multiple gingival recessions: a 6-month study. J Periodontol 80(2):244–252

    CAS  Article  PubMed  Google Scholar 

  3. Barker TS, Cueva MA, Rivera-Hidalgo F, Beach MM, Rossmann JA, Kerns DG, Crump TB, Shulman JD (2010) A comparative study of root coverage using two different acellular dermal matrix products. J Periodontol 81(11):1596–1603

    Article  PubMed  Google Scholar 

  4. Breault LG, Bilman MA, Lewis D (1997) Report of a gingival “surgical cyst” developing secondarily to a subepithelial connective tissue graft. J Periodontol 68:392–395

    CAS  Article  PubMed  Google Scholar 

  5. Cheung WS, Griffin TJ (2004) A comparative study of root coverage with connective tissue and platelet concentrate grafts: 8-month results. J Periodontol 75(12):1678–1687

    Article  PubMed  Google Scholar 

  6. De Souza SL, Novaes AB Jr, Grisi DC, Taba M Jr, Grisi MF, de Andrade PF (2008) Comparative clinical study of a subepithelial connective tissue graft and acellular dermal matrix graft for the treatment of gingival recessions: six- to 12-month changes. J Int Acad Periodontol 10(3):87–94

    PubMed  Google Scholar 

  7. Fowler EB, Francis PO, Goho C (2003) Use of acellular dermal matrix allograft for management of inadequate attached gingiva in a young patient. Mil Med 168(3):261–265

    PubMed  Google Scholar 

  8. Griffin TJ, Cheung WS, Zavras AI, Damoulis PD (2006) Postoperative complications following gingival augmentation procedures. J Periodontol 77(12):2070–2079

    Article  PubMed  Google Scholar 

  9. Herford AS, Lu M, Akin L, Cicciù M (2012) Evaluation of a porcine matrix with and without platelet-derived growth factor for bone graft coverage in pigs. Int J Oral Maxillofac Implants 27(6):1351–1358

    PubMed  Google Scholar 

  10. Jankovic S, Aleksic Z, Milinkovic I, Dimitrijevic B (2010) The coronally advanced flap in combination with platelet-rich fibrin (PRF) and enamel matrix derivative in the treatment of gingival recession: a comparative study. Eur J Esthet Dent 5(3):260–273

    PubMed  Google Scholar 

  11. Jankovic S, Aleksic Z, Klokkevold P, Lekovic V, Dimitrijevic B, Kenney EB, Camargo P (2012) Use of platelet-rich fibrin membrane following treatment of gingival recession: a randomized clinical trial. Int J Periodontics Restorative Dent 32(2):e41–e50

    PubMed  Google Scholar 

  12. Life Cell accessed from http://en.wikipedia.org/wiki/LifeCell at 12:11 PM on 22/02/2013

  13. Nevins M, Nevins ML, Kim SW, Schupbach P, Kim DM (2011) The use of mucograft collagen matrix to augment the zone of keratinized tissue around teeth: a pilot study. Int J Periodontics Restorative Dent 31(4):367–373

    PubMed  Google Scholar 

  14. Rotundo R, Pini-Prato G (2012) Use of a new collagen matrix (mucograft) for the treatment of multiple gingival recessions: case reports. Int J Periodontics Restorative Dent 32(4):413–419

    PubMed  Google Scholar 

  15. Sanz M, Lorenzo R, Aranda JJ, Martin C, Orsini M (2009) Clinical evaluation of a new collagen matrix (Mucograft prototype) to enhance the width of keratinized tissue in patients with fixed prosthetic restorations: a randomized prospective clinical trial. J Clin Periodontol 36(10):868–876

    Article  PubMed  Google Scholar 

  16. Shanmugam M, Sivakumar V, Anitha V, Sivakumar B (2012) Clinical evaluation of alloderm for root coverage and colour match. J Indian Soc Periodontol 16(2):218–223

    CAS  PubMed Central  Article  PubMed  Google Scholar 

  17. Sonick M, Hwang D (2011) The dependability of connective tissue grafting for the resolution of full-mouth recession. Compend Contin Educ Dent 32(1):48–53

    PubMed  Google Scholar 

  18. Thoma DS, Benić GI, Zwahlen M, Hämmerle CH, Jung RE (2009) A systematic review assessing soft tissue augmentation techniques. Clin Oral Implants Res Suppl 4:146–165

    Article  Google Scholar 

  19. Vastardis S, Yukna RA (2003) Gingival/soft tissue abscess following subepithelial connective tissue graft for root coverage: report of three cases. J Periodontol 74(11):1676–1681

    Article  PubMed  Google Scholar 

  20. Vinaya Kumar R, Shubhashini N (2013) Platelet rich fibrin: a new paradigm in periodontal regeneration. Cell Tissue Bank 14(3):453–463

    CAS  Article  PubMed  Google Scholar 

  21. Wagshall E, Lewis Z, Babich SB, Sinensky MC, Hochberg M (2002) Acellular dermal matrix allograft in the treatment of mucogingival defects in children: illustrative case report. ASDC J Dent Child 69(1):39–43

    PubMed  Google Scholar 

  22. Wei PC, Geivelis M (2003) A gingival cul-de-sac following a root coverage procedure with a subepithelial connective tissue submerged graft. J Periodontol 74(9):1376–1380

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

We would like to acknowledge Mr Matthias Matthes, Managing Director, Dentegris International, Germany, the makers of MucoMatrixX for supporting us with samples of MucoMatrixX. We would like to acknowledge Dr Umesh Chandra Prasad, Professor and Head, Department of Oral Pathology, Kanti Devi Dental College and Hospital, Mathura, Uttar Pradesh, India for contributing Figure 2.

Author information

Affiliations

Authors

Corresponding author

Correspondence to Srinivas Sulugodu Ramachandra.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Ramachandra, S.S., Rana, R., Reetika, S. et al. Options to avoid the second surgical site: a review of literature. Cell Tissue Bank 15, 297–305 (2014). https://doi.org/10.1007/s10561-013-9395-8

Download citation

Keywords

  • MucomatrixX
  • Alloderm®
  • Mucograft®
  • Platelet rich fibrin
  • Puros® dermis
  • Second surgical site
  • Soft tissue allograft