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SUB-EPITHELIAL CONNECTIVE TISSUE GRAFT

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Drsumitra's picture
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Joined: 6 Oct 2011

 The Sub-Epithelial Connective Tissue Graft ("Sub-Epi Graft")

The sub-epithelial connective tissue graft is a procedure that is designed to:

1. Cover Recession (when a lateral "pedicle" graft can't be done)

2. Re-Construct Areas of Bone Loss or Bone Resporption

1. Cover Recession
When there is not enough thick tissue next to an area of recession and a lateral graft can't be done, the "Sub-Epi" graft can be done. This usually uses a piece of gum tissue taken from the roof of the mouth but fromunder the superficial, surface gum tissue. An option, in some cases, is to use a "man-made" membrane instead of taking any tissue from the roof of the mouth.



In the surgical procedure, the gum tissue or "man-made" membrane is placed over the root of the tooth. A flap of gum tissue is raised from the base of the recession in order to cover the gum tissue or membrane -- in order to provide a blood supply to the graft. This creates the potential to create healthy, tough tissue and also create a better cosmetic result.

2. Reconstruct Areas of Bone Loss or Bone Resorption

When some of the upper front teeth are removed (usually if a tooth fractured or a root canal failed), there may be the excessive loss of bone from where the tooth came out. This can leave an unsightly, or even ugly "depression" in the gum tissue. Too often, when a "dummy" tooth is replaced into the mouth, this "depression" requires the "dummy" or replacement tooth to be too long and unsightly. Before the replacement tooth is to be made, the "Sub-epi" graft should be done in order to reconstruct this deformed area. The result will be a more natural looking tooth and a happier smile.

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drsushant's picture
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SUB-EPITHELIAL CONNECTIVE TISSUE GRAFT

Free Gingival Graft v/s Sub-Epithelial Connective Tissue Graft: What is recommended?

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DrAnil's picture
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SUB-EPITHELIAL CONNECTIVE TISSUE GRAFT

A free gingival graft is best. This can be accomplished nicely during a second stage, or uncovering surgery. Implants are placed using a submerged protocol. Then during the uncovering surgery, a free graft is used and guided with healing abutments. Impressions can usually be taken in 8-10 weeks.

If the patient is very cosmetically oriented and you think may object to a graft of a different color, the connective tissue graft is the best choice then. There is also less discomfort associated with a subepithelial connective tissue graft donor site.
As far as predictability, both are very predictable, since they would be placed on a vascular bed at the recipient site.

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SUB-EPITHELIAL CONNECTIVE TISSUE GRAFT

 

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