JIACD
The Journal of Implant & Advanced Clinical Dentistry
Pat Allen Papilla Tunnel Technique for Alloderm
Sun, 06/06/2010 - 07:10 — Steve Wilson
I went this year to a 2 day course on Alloderm using the Dr Pat Allen Papilla Tunnel Technique I did a proceduce on a patient the other day from teeth #7 to #3. The patient was pre-medicated with Zithromax (250mg) the day before surgery and completed there after. Ibuprofen 800mg q6-8h for pain. Medrol dose pack Peridex bid 2-3 weeks as laid out in Pats course. I did the alternate papilla tunnel technique. Lifting the papilla was difficult and my final results where less than satisfactory. Anyone care to share their thoughts on the Alternate Papilla Tunnel Technique? Whats the best way to lift the papilla? What results do you get? How can I improve my results?


Tunnel vs flap for soft tissue allografts.
This article speaks volumes
Root coverage using acellular dermal matrix and comparing a coronally positioned tunnel to a coronally positioned flap approach.
Papageorgakopoulos G, Greenwell H, Hill M, Vidal R, Scheetz JP.
Graduate Periodontics, School of Dentistry, University of Louisville, Louisville, KY 40292, USA.
Abstract
BACKGROUND: The primary aim of this randomized, controlled, masked clinical trial was to compare the percentage of root coverage obtained with a coronally positioned flap plus acellular dermal matrix (ADM) allograft to that of a tunnel technique plus ADM 4 months post-surgically. METHODS: Twenty-four subjects with one site with > or =3 mm Miller Class I or II recession were treated and followed for 4 months. Twelve patients received a coronally positioned flap plus ADM and were considered the positive control group (CPF). The test group consisted of 12 subjects treated with a coronally positioned tunnel technique plus ADM (TUN). Subjects were randomly selected by a coin toss to receive the test or control treatment. RESULTS: The mean facial recession defect at the initial examination for the TUN group was 3.1 +/- 0.3 mm; this was reduced to 0.7 +/- 0.9 mm at the 4-month examination for a gain of 2.4 +/- 1.0 mm or 78% defect coverage (P <0.05). The mean facial recession defect at the initial examination for the CPF group was 3.4 +/- 0.8 mm; it was reduced to 0.2 +/- 0.3 mm at the 4-month examination for a gain of 3.2 +/- 0.9 mm or 95% defect coverage (P <0.05). There was no statistically significant difference between groups (P >0.05). CONCLUSIONS: The coronally positioned flap plus ADM produced a defect coverage of 95%, whereas the tunnel technique plus ADM produced only 78% coverage. This difference was considered clinically significant but was not statistically significant.
Alloderm, Root coverage and bruxism
Richard you are correct. You have to correct the bruxism otherwise you will not get the desired root coverage.
Agree entirely.
TUNNEL TECHNIQUE
This is a time sensitive procedure. I have noticed that one can get less than desirable results in bruxers, in particular the quadrants or teeth that are directly involved with clenching or bruxing.
Pat Allen Papilla Tunnel Technique for Alloderm---Just Flap it
While I love the results pat gets. There are articles out there to sure you can get the same results flapping the site and placing the alloderm vs tunneling it in.
Save the time and elevate a flap.