JIACD
The Journal of Implant & Advanced Clinical Dentistry
JIACD
© 2008 Journal of Implant and Advanced Clinical Dentistry. Privacy Policy | Terms & Conditions
Connective tissue all the way
CTG are best for root coverage. The only time I use alloderm is if I need to do a whole mouth coverage case.
CTG VS FGG depends on what you are doing
As a periodontist, we mostly abandoned free gingival grafting many years ago. Subepithelial connective tissue grafts can yield a much higher percentage of success. In an area for root coverage, there have been reports in the literature about the change in surface keratinization over SECT’s. Alternatively, if you are looking for clinical “pink” tissue in addition to histologically keratinized tissue, you can apically reposition the mucosa 8 weeks after surgery. You get a greater percentage of root coverage with a CTG over a FGG.
In areas with a shallow vestibule a FGG in an area with generally high muscle pull, it may not be easy for you to stabilize ideally. You may have better take with a fully or partially buried SECT graft.
If you are increase the zone of KG only without root coverage I think that both can be predictally be used. But the Free Gingival Graft can achieve the keratinized zone earlier than the connective tissue graft. I recommend that both in first and in the second stage surgery or immediate loading use the subepitelial connective tissue graft. I use the Free Gingival Graft when no keratinized mucosa is present and before the implant surgery. After tree months, the implants can be positioned.
Connectice tissue Grafts Vs Soft tissue Allograft
You definitely get more root coverage, more KG, More attached tissue with CTG over allograft.
The advantage of allograft is you can do a whole mouth in 1 visit.
The whole mouth? Really? I don't think so
I don't know anyone using allograft soft tissue to do the entire mouth in one shot. That is the problem with this stuff. People think it is sooooooo easy to use. "Just slap it in with a few stitches and you are good to go!" That a'int how it happens in real life.
You Can do whole mouth root coverage in 1 visit with Alloderm
No offense but you can do the whole mouth in 1 visit. I am not saying it is easy. It isn't but certainly this is what it is designed for. It is technically demanding. I would be happy to send you some case results of some of my cases. Dont knock it till you try it.
CTG Over Allograft: My 5 cents.
As an oral surgeon I dont do much root coverage but all my perio colleagues tell me that CTG work much better for root coverage.
Root Coverage: Hands Down CTG over Allografts
In my opinion, connective tissue grafts work much better for root coverage then allografts. You get much better coverage and KG with CTG.
The advantage of the allograft is you can treat more teeth at one time where CTG you are limited.
But Horowitz says allograft is better than CTG
I just saw his ad flash up on the side of the website. He is a pretty famous periodontist, right? If he says dermis is the best thing he has ever used, why should I refer someone out to have their palate cut? That is the only reason why I have not tried a connective tissue graft, I do not want to cut the palate. If all I have to do is make a few cuts in the gum and stick in some dermis, that sounds pretty doable for me.