Autogenous gingival grafts as epithelial barriers for immediate implants: Case reports
The aim of this article was to describe a technique using autogenous gingival grafts of masticatory mucosa for barrier for immediate implants. The first case was a 29-year-old male who fractured 9. This tooth was extracted and an HA-coated implant placed. The investigators harvested a free gingival graft from the tuberosity area. At two weeks postsurgery the graft was covering the implant, and at stage 2 they found that the implants had osseointegrated. The implant was restored eight months after.
Case 2 was a 39-year-old whose 9 was extracted due to a periapical lesion. An 18 mm screw-type implant was placed, but due to the insufficient housing the implant fenestrated. Again, they took tissue from the tuberosity, and at 6-8 weeks the implant was exposed. Antibiotics were given and there was no evidence of infection. At stage 2 the implants were osseointegrated and a two-unit bridge was placed, splinting the implant to tooth 8. Case 3 was on a 44 year-old with a mobile deciduous 29. This was replaced with a 10 mm screw-type implant and autogenous graft. At stage 2 the implant was osseointegrated and in one month restored. Case 4 was on a 69-year-old female with an unrestorable tooth 5 due to caries. This was replaced with a 10 mm screw-type implant and covered with a FGG. Stage 2 at six months revealed an osseointegrated implant which was subsequently restored with a four-unit bridge. This article presents the technique of utilizing an FGG instead of a membrane. This eliminates the problem of antigenicity and potential of infection we might expect from an exposed membrane.[M.C.R.]
Evian, C.I., and S. Cutler, J Periodont, 65:201, 1994