Use of acellular dermal matrix allograft for management of inadequate attached gingiva in a young patient

Abstract

Young patients are notorious for exhibiting inconsistent hygiene. Compounding this issue can be the need for orthodontic intervention. Periodontal surgery is often required prior to orthodontics to augment areas of inadequate gingiva. These surgical procedures traditionally require a second surgical site, usually the hard palate. The requirement to harvest donor tissue necessitates the need for additional local anesthesia and surgical trauma to a site often distant from the area of concern. After surgery, the donor site usually results in more discomfort for the patient than the recipient location. When treating young patients, minimizing dental surgical trauma and treatment time is advantageous. If a graft material could be used to replace the classic palatal or free gingival graft, then periodontal surgery would be better accepted by the adolescent patient. In this case report, an 11-year-old girl was treatment planned for orthodontics. She presented with thin gingival and minimal attached tissues in the mandibular anterior sextant. As an alternative to free autogenous grafting, an acellular dermal matrix allograft was used to augment these areas, negating the requirement for a second palatal surgical procedure. Healing was uneventful, and the results were judged to be successful in terms of increasing the band of attached tissue, color match, ease of the procedure, and rapid recovery of the patient.