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Ask UsDr. R. from Hawaii asks:
Are there any indications for using AlloDerm (Lifecell) around dental implants? If so, what is the preferred technique for placing the Alloderm? Does placement of AlloDerm have any effect on osseointegration? Are there contraindications for placement of AlloDerm?
[Ed. AlloDerm is an acellular dermal matrix derived from donated human skin tissue supplied by US AATB-compliant tissue banks utilizing the standards of the American Association of Tissue Banks (AATB) and Food and Drug Administration’s (FDA) guidelines. Since AlloDerm is regarded as minimally processed and not significantly changed in structure from the natural material, the FDA has classified it as banked human tissue.]
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4 Responses to “ AlloDerm and Dental Implants ”
Dr. R.:
There is contraindication in the use of alloderm with implants. The procedure is simple, you can use it during first stage surgery to get a thicker tissue for your porterior rehab or you can use it as a graft technique during second stage surgery to obtain better cosmetic results.
I ususally make a partial thickness flap, place the alloderm and suture covering it completely.
you will get a nice and thick gum.
Cheers
Alloderm can be layed over the implant to cover the coverscrew and then suture the patient’s attached gingival tissue over this so that the you can prevent premature perforation of the implant under a flipper. It can also accentuate your emergence profile in a thin gingival biotype.One negative about Alloderm is that it can smell terrible if it is exposed. I suggest a lot of scope and breath mints if this happens.Ha!
We used AlloDerm(R) to gain keratinized tissues around 2 implants in the mandible - even had an implant retained surgical stent to protect the site during healing. Cannot compare whether this or FGG is better in gain in keratinised tiss width, but worked well for that case and healed very nicely. It has to slough off eventually and replaced by tissues from the host bed - which explains the appearance/smell. However, in that case at least, outcome was great.
Alloderm is great to augment the tissue. You can use it a couple of ways:
1) As a free gingival graft - gain attached gingiva and increase vestibular depth. Make sure basement membrane is facing out and you have to use a periodressing.
2) I prefer to use it as a connective tissue graft so you either flap or pouch around the implant(s). This is a bit technique sensitive but you do not have to worry about which side is facing up down or otherwise. The end result is good attached gingiva (not to be confused with Keratinized gingiva) and if done with intent you can gain height of the gingival margin.
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