Simultaneous placement of an interpositional free gingival graft with nonsubmerged implant placement
Identifieur interne : 001F04 ( Pmc/Curation ); précédent : 001F03; suivant : 001F05Simultaneous placement of an interpositional free gingival graft with nonsubmerged implant placement
Auteurs : Joo-Yeon Sohn [Corée du Sud] ; Jung-Chul Park [Corée du Sud] ; Kyoo-Sung Cho [Corée du Sud] ; Chang-Sung Kim [Corée du Sud]Source :
- Journal of Periodontal & Implant Science [ 2093-2278 ] ; 2014.
Abstract
Various surgical techniques target achieving adequate keratinized tissue around dental implants; however, these techniques are usually performed before implant placement or upon the exposure of submerged implants. The aim of this case report is to describe a simultaneous placement of an interpositional free gingival graft (iFGG) with that of nonsubmerged implants in a patient lacking keratinized tissue and to assess the long-term outcome of this grafted gingiva.
A wedge-shaped free gingnival graft (FGG), including an epithelium-connective tissue (E-C) portion and a connective-tissue-only (CT) portion, was harvested from the palate. The CT portion was inserted under the buccal flap, and the E-C portion was secured tightly around the implants and to the lingual flap.
At the 8-year follow-up, the gingival graft remained firmly attached and was well maintained, with no conspicuous shrinkage or reported discomfort during oral hygiene procedures. The use of an iFGG at a nonsubmerged implant placement minimizes the required number of surgical steps and patient discomfort while providing adequate buccal keratinized tissue.
Therefore, the technique could be considered an alternative method in increasing the keratinized tissue for cases that have a minimal amount of keratinized tissue.
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DOI: 10.5051/jpis.2014.44.2.94
PubMed: 24778904
PubMed Central: 3999358
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Simultaneous placement of an interpositional free gingival graft with nonsubmerged implant placement</title><author><name sortKey="Sohn, Joo Yeon" sort="Sohn, Joo Yeon" uniqKey="Sohn J" first="Joo-Yeon" last="Sohn">Joo-Yeon Sohn</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul</wicri:regionArea></affiliation></author><author><name sortKey="Park, Jung Chul" sort="Park, Jung Chul" uniqKey="Park J" first="Jung-Chul" last="Park">Jung-Chul Park</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul</wicri:regionArea></affiliation></author><author><name sortKey="Cho, Kyoo Sung" sort="Cho, Kyoo Sung" uniqKey="Cho K" first="Kyoo-Sung" last="Cho">Kyoo-Sung Cho</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul</wicri:regionArea></affiliation></author><author><name sortKey="Kim, Chang Sung" sort="Kim, Chang Sung" uniqKey="Kim C" first="Chang-Sung" last="Kim">Chang-Sung Kim</name><affiliation wicri:level="1"><nlm:aff id="A2">Department of Periodontology, Research Institute for Periodontal Regeneration, Oral Science Research Center, Yonsei University College of Dentistry, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Periodontology, Research Institute for Periodontal Regeneration, Oral Science Research Center, Yonsei University College of Dentistry, Seoul</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">24778904</idno><idno type="pmc">3999358</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3999358</idno><idno type="RBID">PMC:3999358</idno><idno type="doi">10.5051/jpis.2014.44.2.94</idno><date when="2014">2014</date><idno type="wicri:Area/Pmc/Corpus">001F04</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001F04</idno><idno 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last="Park">Jung-Chul Park</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul</wicri:regionArea></affiliation></author><author><name sortKey="Cho, Kyoo Sung" sort="Cho, Kyoo Sung" uniqKey="Cho K" first="Kyoo-Sung" last="Cho">Kyoo-Sung Cho</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul</wicri:regionArea></affiliation></author><author><name sortKey="Kim, Chang Sung" sort="Kim, Chang Sung" uniqKey="Kim C" first="Chang-Sung" last="Kim">Chang-Sung Kim</name><affiliation wicri:level="1"><nlm:aff id="A2">Department of Periodontology, Research Institute for Periodontal Regeneration, Oral Science Research Center, Yonsei University College of Dentistry, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Periodontology, Research Institute for Periodontal Regeneration, Oral Science Research Center, Yonsei University College of Dentistry, Seoul</wicri:regionArea></affiliation></author></analytic><series><title level="j">Journal of Periodontal & Implant Science</title><idno type="ISSN">2093-2278</idno><idno type="eISSN">2093-2286</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Purpose</title><p>Various surgical techniques target achieving adequate keratinized tissue around dental implants; however, these techniques are usually performed before implant placement or upon the exposure of submerged implants. The aim of this case report is to describe a simultaneous placement of an interpositional free gingival graft (iFGG) with that of nonsubmerged implants in a patient lacking keratinized tissue and to assess the long-term outcome of this grafted gingiva.</p></sec><sec><title>Methods</title><p>A wedge-shaped free gingnival graft (FGG), including an epithelium-connective tissue (E-C) portion and a connective-tissue-only (CT) portion, was harvested from the palate. The CT portion was inserted under the buccal flap, and the E-C portion was secured tightly around the implants and to the lingual flap.</p></sec><sec><title>Results</title><p>At the 8-year follow-up, the gingival graft remained firmly attached and was well maintained, with no conspicuous shrinkage or reported discomfort during oral hygiene procedures. The use of an iFGG at a nonsubmerged implant placement minimizes the required number of surgical steps and patient discomfort while providing adequate buccal keratinized tissue.</p></sec><sec><title>Conclusions</title><p>Therefore, the technique could be considered an alternative method in increasing the keratinized tissue for cases that have a minimal amount of keratinized tissue.</p></sec><sec><title>Graphical Abstract</title><p><graphic xlink:href="jpis-44-94-ab001.jpg" position="float" orientation="portrait"></graphic></p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Ericsson, I" uniqKey="Ericsson I">I Ericsson</name></author><author><name sortKey="Lindhe, J" uniqKey="Lindhe J">J Lindhe</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Salonen, Ma" uniqKey="Salonen M">MA Salonen</name></author><author><name sortKey="Oikarinen, K" uniqKey="Oikarinen K">K 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<front><journal-meta><journal-id journal-id-type="nlm-ta">J Periodontal Implant Sci</journal-id><journal-id journal-id-type="iso-abbrev">J Periodontal Implant Sci</journal-id><journal-id journal-id-type="publisher-id">JPIS</journal-id><journal-title-group><journal-title>Journal of Periodontal & Implant Science</journal-title></journal-title-group><issn pub-type="ppub">2093-2278</issn><issn pub-type="epub">2093-2286</issn><publisher><publisher-name>Korean Academy of Periodontology</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">24778904</article-id><article-id pub-id-type="pmc">3999358</article-id><article-id pub-id-type="doi">10.5051/jpis.2014.44.2.94</article-id><article-categories><subj-group subj-group-type="heading"><subject>Case Report</subject></subj-group></article-categories><title-group><article-title>Simultaneous placement of an interpositional free gingival graft with nonsubmerged implant placement</article-title></title-group><contrib-group><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">http://orcid.org/0000-0002-4229-5869</contrib-id><name><surname>Sohn</surname><given-names>Joo-Yeon</given-names></name><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">http://orcid.org/0000-0002-2041-8047</contrib-id><name><surname>Park</surname><given-names>Jung-Chul</given-names></name><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">http://orcid.org/0000-0002-6777-5287</contrib-id><name><surname>Cho</surname><given-names>Kyoo-Sung</given-names></name><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">http://orcid.org/0000-0003-3902-1071</contrib-id><name><surname>Kim</surname><given-names>Chang-Sung</given-names></name><xref ref-type="aff" rid="A2">2</xref></contrib></contrib-group><aff id="A1"><label>1</label>Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea.</aff><aff id="A2"><label>2</label>Department of Periodontology, Research Institute for Periodontal Regeneration, Oral Science Research Center, Yonsei University College of Dentistry, Seoul, Korea.</aff><author-notes><corresp>Correspondence: Chang-Sung Kim. Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea. <email>dentall@yuhs.ac</email>, Tel: +82-2-2228-3186, Fax: +82-2-392-0398</corresp></author-notes><pub-date pub-type="ppub"><month>4</month><year>2014</year></pub-date><pub-date pub-type="epub"><day>24</day><month>4</month><year>2014</year></pub-date><volume>44</volume><issue>2</issue><fpage>94</fpage><lpage>99</lpage><history><date date-type="received"><day>27</day><month>2</month><year>2014</year></date><date date-type="accepted"><day>21</day><month>3</month><year>2014</year></date></history><permissions><copyright-statement>Copyright © 2014 Korean Academy of Periodontology</copyright-statement><copyright-year>2014</copyright-year><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by-nc/3.0/"><license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc/3.0/">http://creativecommons.org/licenses/by-nc/3.0/</ext-link>).</license-p></license></permissions><abstract abstract-type="graphical"><sec><title>Purpose</title><p>Various surgical techniques target achieving adequate keratinized tissue around dental implants; however, these techniques are usually performed before implant placement or upon the exposure of submerged implants. The aim of this case report is to describe a simultaneous placement of an interpositional free gingival graft (iFGG) with that of nonsubmerged implants in a patient lacking keratinized tissue and to assess the long-term outcome of this grafted gingiva.</p></sec><sec><title>Methods</title><p>A wedge-shaped free gingnival graft (FGG), including an epithelium-connective tissue (E-C) portion and a connective-tissue-only (CT) portion, was harvested from the palate. The CT portion was inserted under the buccal flap, and the E-C portion was secured tightly around the implants and to the lingual flap.</p></sec><sec><title>Results</title><p>At the 8-year follow-up, the gingival graft remained firmly attached and was well maintained, with no conspicuous shrinkage or reported discomfort during oral hygiene procedures. The use of an iFGG at a nonsubmerged implant placement minimizes the required number of surgical steps and patient discomfort while providing adequate buccal keratinized tissue.</p></sec><sec><title>Conclusions</title><p>Therefore, the technique could be considered an alternative method in increasing the keratinized tissue for cases that have a minimal amount of keratinized tissue.</p></sec><sec><title>Graphical Abstract</title><p><graphic xlink:href="jpis-44-94-ab001.jpg" position="float" orientation="portrait"></graphic></p></sec></abstract><kwd-group><kwd>Free gingival graft</kwd><kwd>Interpositional onlay graft</kwd><kwd>Keratinized tissue</kwd><kwd>Nonsubmerged implant</kwd></kwd-group><funding-group><award-group><funding-source country="KR">Yonsei University College of Dentistry for 2011</funding-source><award-id>6-2011-0052</award-id></award-group></funding-group></article-meta></front><floats-group><fig id="F1" orientation="portrait" position="float"><label>Figure 1</label><caption><p>Preoperative clinical photographs and radiograph. (A) Occlusal view of the edentulous ridge of the right mandibular area. The dotted line indicates the buccal and lingual mucogingival junctions. (B) Buccal view. (C) Slight vertical bone resorption was observed in the posterior area.</p></caption><graphic xlink:href="jpis-44-94-g001"></graphic></fig><fig id="F2" orientation="portrait" position="float"><label>Figure 2</label><caption><p>The recipient site preparation. (A) The dotted line represents the horizontal incision line. (B) Healing caps were connected after installing the implants. (C) The template for guiding the palatal incision was constructed from tinfoil.</p></caption><graphic xlink:href="jpis-44-94-g002"></graphic></fig><fig id="F3" orientation="portrait" position="float"><label>Figure 3</label><caption><p>The palatal donor site preparation. (A) The incision for the graft was carried out using a tinfoil template. (B) A presuture was created for immediate adaptation and fixation, and then, the interpositional free gingival graft, containing connective tissue, was harvested from the palate. (C) A three-dimensional schematic view of the graft. The partial-thickness graft consists of an epithelium-connective tissue (E-C) portion and a connective-tissue-only (CT) portion.</p></caption><graphic xlink:href="jpis-44-94-g003"></graphic></fig><fig id="F4" orientation="portrait" position="float"><label>Figure 4</label><caption><p>Placement of the interpositional free gingival graft (FGG). (A) The interpositional FGG was positioned over the recipient bed, and the connective-tissue-only portion was inserted under the buccal flap. The presuture silk was tied around the healing abutments using the sling suturing technique. (B) The buccal and lingual flaps were sutured with grafted gingiva, and primary closure was obtained. (C) Occlusal view after 1 month of healing.</p></caption><graphic xlink:href="jpis-44-94-g004"></graphic></fig><fig id="F5" orientation="portrait" position="float"><label>Figure 5</label><caption><p>Healing states of the grafted gingiva after 1 year and 8 years. (A) Buccal view after 1 year of healing. (B) Buccal view after 8 years of healing.</p></caption><graphic xlink:href="jpis-44-94-g005"></graphic></fig><fig id="F6" orientation="portrait" position="float"><label>Figure 6</label><caption><p>Periapical radiographs of the implants after 1 year and 8 years. (A) Postoperative, 1 year. (B) Postoperative, 8 years. Saucerization occurred around fixtures, but there was no additional alveolar bone resorption in the interproximal area up to the 8-year follow-up.</p></caption><graphic xlink:href="jpis-44-94-g006"></graphic></fig><table-wrap id="T1" orientation="portrait" position="float"><label>Table 1</label><caption><p>The width (mm) of keratinized gingiva on the buccal side of implant-healing abutments was measured with a periodontal probe (CP15UNC, Hu Friedy, Chicago, IL, USA).</p></caption><graphic xlink:href="jpis-44-94-i001"></graphic></table-wrap></floats-group></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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