The connective tissue graft (CTG) is considered the material of choice in treating gingival or mucosal recessions around teeth and implants. Nowadays it is mainly used to recreate/augment keratinized tissue (KT) width, which is most important for dental implants for patient comfort and plaque control. It has been shown that CTG is able to induce the keratinization of the overlying epithelium, especially if mainly composed by lamina propria and collagen fibers. On the contrary, a CTG from the deep palate seems not to have the same potential of inducing keratinization as superficial CTG, cause of the large amount of adipose and glandular tissue. Nevertheless, the choice of harvesting technique is usually dictated by the anatomy of the site (such as, the palatine artery, shape of the palatal vault, palatal thickness), the required graft thickness, and the clinician's preference.
Which is the best location for obtaining a graft and the ideal harvesting technique that minimizes the patient's morbidity?
Histologic and molecular analysis of tuberosity soft tissue graft
Compared to the SCTG, the tCTG present a denser lamina propria (72.79% for the tCTG vs. 51.08% for the SCTG). The letterature reported that the high amounts of submucosa tissue may result in more graft shrinkage and less volume gain, for this reason it is possible to consider tCTG as a viable alternative to a deep palatal CTG. However tCTG resembles a more fibrotic tissue with a tendency for a hyperplastic response and, therefore, as suggested by Dellavia et al., its thickness should be limited to <3 mm. Conclusions The maxillary tuberosity is a valid donor site for harvesting a soft tissue graft. Nevertheless, this procedure may result in an unesthetic hyperplastic response, for this reason when esthetic concerns are of primary concern, a CTG harvested from the palate may provide better outcomes.
Oral surgery 17 April 2019
Oral surgery 06 March 2019
Authors: G. Mergoni, I. Giovannacci, G. Giunta, G. Ghidini, M. Meleti, M. Manfredi, P. Vescovi
An 11-year-old patient was sent to out observation by her pediatrician for a maxillary gingival lesion that had arisen about 2 months earlier and...