Sullivan, H., Atkins, J., Free autogenous gingival grafts. I. Principles of successful grafting. Periodontics. 6:5, 1968

The object is to attempt to correlate the surgical principles previously developed in plastic surgery to periodontics

• Recipient Site - The most important principle in recipient site selection is the capacity of the recipient bed to form capillaries outgrowths for vascularization of the graft. Adequate hemostasis of the recipient bed is another essential principle for successful grafting
• Recipient Site Preparation - the recipient site's epithelium, connective tissue, and muscle fibers are sharply dissected down to the periosteum. This forms a rigid base, for immobilization
• Donor Site - Basically: edentulous ridge tissue, attached gingiva, palatal mucosa. avoid post-extraction sites, inflamed or hyperplastic tissue. Palatal most common- anterior palate is rich in fat, posterior palate contains the greater palatine foramen. Grafts classified into full-thickness and split-thickness, split-thickness is further subdivided into thin, intermediate or thick. With immediate detachment of donor there is shrinkage this is primary contraction. Secondary contraction occurs with healing . Less primary contraction with thick donor. Thinner graft can easily be maintained by diffusion and is easier o vascularize.
• Donor site preparation - an access incision is made allowing the surgeon to observe the thickness of the graft to be removed.
• Immobilization - vestibular extension if needed. steps- suturing, formation of the fibrin clot, placement of the rubber dam and dressing, 5-0 atraumatic needle, pressure 5 minutes
• Stages of a graft Take - plasmic circulation, vascularization, and organic union, plasmatic circulation occurs most efficient throughout the fibrin clot.

Back: Soft Tissue Articles
Menu: Literature Review Topics
Home: PIC Homepage