Correcting mucogingival deformities for pescatarian patients: A clinical case study.

Abstract

This clinical case study is to highlight the improvement of periodontal health of mandibular canines using a soft tissue alternative of fish origin, a piscine graft. A 37-year-old female patient was referred to a periodontal practice for evaluation of mucogingival deformities around teeth #22 and #27 that were also diagnosed with recession, lack of keratinized tissue (KT), and bilateral high frenum attachment. Multiple soft tissue treatment options were presented to the patient, including autogenous, allograft, or xenograftporcine or piscine. Given the patient's dietary preference, piscine option was preferred. The procedures were completed one at a time, first #22 and later #27, using the standard of care procedures for correcting mucogingival deformities using soft tissue alternatives. Post-surgical visits were scheduled at regular intervals (2, 4, 12, 24, 52 weeks) to evaluate the clinical outcomes. Healing was uneventful and clinical outcomes reveal correction of the mucogingival deformities. The amount of KT at the 52 weeks healing time, measured using an intraoral scanner was 2.12 mm on #22 and 1.78 mm on #27. Within this clinical case's scope, piscine xenograft demonstrates to be a safe and effective soft tissue alternative to correct mucogingival deformities, increasing the KT width and achieving recession coverage. In addition, integration of patient's preference may lead to increased case acceptance and patient compliance. What new information is this case providing? The use of a soft tissue alternative of piscine origin that was selected based on the patient's preference to correct bilateral combined mucogingival deformities (recession, lack of KT, and aberrant frenum attachment) around teeth. What is a key step to integrating this soft tissue alternative in clinical practice? The pre-hydration of the soft tissue alternative is preferred, compared to other soft tissue alternatives that might not require hydration (xenograft bovine origin). What are the limitations to success in this case? Confirming with the patient no pre-existing fish allergies.