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Newsletter Articles

Case Study 11 Acellular Dermal Matrix (Alloderm) and Subepithelial Connective Tissue Grafts

AlloDerm® is real human tissue that is decellularized to remove the risk of rejection or inflammation. It is then freeze dried through a patented process that maintains the crucial elements of the tissue structure (collagen, elastin, proteoglycans) and packaged with a shelf life up to two years. AlloDerm is available in various sizes to increase keratinized gingiva, for soft tissue flap extensions over bone grafts, and for recession defects. It can be used as an effective alternative to autografts.

Uses:

• For increasing keratinized tissue
  
• Functions as graft or implant for soft tissue repair
  
• Excellent for recession defects, showing similar amounts of root coverage and esthetically acceptable results when compared to the connective tissue grafts

AlloDerm is an acellular dermal matrix designed to serve as a biologic scaffold for normal tissue remodeling. AlloDerm contains both the structure and the biochemical information to direct normal revascularization and cell repopulation as blood vessels, collagens, proteoglycans and elastin are preserved. This extracelullar matrix contains the blood vessel channels which serve as conduits for revascularization; collagens, proteoglycans and elastin provide structure and information for cell repopulation; most importantly, preserved proteoglycans and proteins direct the patient's own cells to initiate revascularization and cell repopulation.

In this case, autogenous (palatal) subepithelial connective tissue grafts were used for # 6-7 and 10-11. Alloderm was used for # 19-23 and 26-30. Four teeth are usually about the maximum number of teeth that can be grafted using autogenous palatal connective tissue at one time. In this case, there were a total of 14 teeth to be treated. Using both methods allowed a direct comparison of results. More complete root coverage was obtained using the palatal autogenous tissue, but adequate results can also be obtained with the acellular dermal matrix. Generally, we use the acellular dermal matrix if more than 4 teeth are involved.

Pre-Op Recession Defects	Sutured	3 Month Post-Op