Dr. 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.]
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.
Hello: I would like to know more info from anyone who has had experience with Alloderm in a nasal graft. I recently had re-constructive septoplasty in which Alloderm was used and I can now detect a noticeable odor that I attribute to its presence. Anyone confirmation or commentary would be much appreciated
Hello, I want to know more about Alloderm: What kind of suture material should be used to suture the alloderm and the gingival tissue? Silk or catgut? Which one is better? And in case of using silk, when should I remove the suture?
Regarding Michele’s question on cost for one tooth. I recently had this procedure completed for one tooth and it cost $1600.00. I wish I had done more research before consenting to this procedure. Rather than letting bone grow back, I was convinced that this was a better support for my implant. I am having problems with the alloderm expanding too much. It has raised the gum line even on the front tooth next to it and has bubbled out a bit above all of my top teeth. It has affected the roof of my mouth and even one nasal passage. I feel a lot of pressure with my implant pushing against the newly formed cells. A constant reminder of wishing I made a wiser decision.
I agree with the foul smell if used for septoplasty. I had a revision with alloderm this time. Funky odor like rot/bad breath…that will hopefully go away as the alloderm does!
i m going to study the effects of alloderms for gingival recession in comparision to connective tissue graft. please inform me the mearest supplier to jaipur/dehli in india & how much does it cost with different dimensions.
regard
naresh
Does any body know about alloderm`s back paper remain in GBR ? what happens and does it affect wound healing ?
Yes I have used Alloderm for years and have had multiple negative and positive experiences. First off I want to say when using Alloderm in dental you CAN NOT leave it exposed ,because it has a necrotic odor and a discoloration effect , this is due to it being ” aseptically treated” not sterilized .If you want to leave soft tissue exposed make sure it’s sterilized tissue or ” Irradiated ” , this is the process which the cadaver tissue undergoes at the tissue bank . AC Dermis is great for leaving tissue exposed and it wont discolor or have a foul odor. It also seems to have a higher tensile strength than most other collagen products. Overall I believe Alloderm is a good product except when left exposed .