Dr. S. asks:
I recently had a failure of an Alloderm graft placed via a vertical incision medial to previous extraction site and graft # 10 (in order to keep the incision line off my prior bone graft site and prevent multiple incisions thru the interdental papillae). I felt that I had sufficient relaxation of the pocket to prevent compression.
The graft was folded into a "pillow" and trimmed to fit, reconstituted according to protocol and antibiotics were prescribed. The patient’s flipper did not touch the incision or graft site. It looked great for 8 days and then the patient began to notice erythema and swelling. Eventually she developed purulent exudate from the sulcus distal to #9 and the graft finally extruded thru the facial. I wonder what could have been done to prevent this? Should I have used palatal connective tissue?