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Figure 10. AlloDerm positioned within pouch
over defect area and sutured to palatal wall
of pouch.
“A successful surgical outcome is
dependent on proper pontic
and abutment form beginning
the day of surgery and continuing
through the healing phase.
The same is true for the final
restorations in order to ensure longterm
maintenance of ridge form.”
the teeth adjacent to the edentulous ridge and at one and two-tooth
sites. A gain in tissue thickness of approximately 3 mm can be expected
from a single surgery using a folded AlloDerm graft. At sites
with greater than 3 mm of buccal deficiency, a second surgery may
be necessary. Minimal increase in vertical dimension can be achieved
with the technique described.
Figure 11. Provisional FPD placed following
conversion of ridge-lap pontics to ovate form.
Long-term maintenance of the soft tissue form achieved is dependent
on the support of the adjacent bony walls proximally and the
ovate pontic form crestally. Without the support of the ovate pontic
during the healing phase, there will be loss of the coronal portion
of the augmented site. Shrinkage of the ridge will occur without the
support from the convex form of the pontic maintaining the concave
pontic site in the ridge. Such shrinkage is commonly seen where
modified ridge-lap pontics are used. A successful surgical outcome is
dependent on proper pontic and abutment form beginning the day
of surgery and continuing through the healing phase. The same is
true for the final restorations in order to ensure long-term maintenance
of ridge form.
Conclusion
Figure 12. Improved ridge form three months
after surgery. A second graft at the lateral incisor
site would result in complete restoration of
ridge contour. Esthetic crown lengthening was
performed on the right side at the same time
as the ridge augmentation.
The surgical techniques outlined represent a refinement in the approach
to soft tissue ridge augmentation. The procedures are minimally
invasive microsurgical techniques that enhance wound stability
while reducing morbidity due to the use of AlloDerm. Reduced
discomfort and improved patient satisfaction characterize the postoperative
period.
To contact Dr. Edward Allen, call 877-696-1414, e-mail center@epallendds.com, or visit
www.DrEdwardPAllen.com.
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