Preparation Of Recipient Bed Research Articles

Dimensional changes of keratinized mucosa after accordion versus conventional free gingival graft around dental implants: A randomized two-arm parallel clinical trial.

Free gingival graft (FGG) is the most effective way to increase the apico-coronal width of the keratinized mucosa. In case of limited donor tissue, the accordion technique can be used. This study compared FGG for dimensional and clinical changes using accordion and conventional methods. Ninety-four implants with keratinized tissue deficiency (<2mm) were randomly assigned to treatment with accordion (49 implants) and conventional (45 implants) FGG. Endpoints including apico-coronal keratinized tissue width, vertical shrinkage, vestibular depth, probing depth, bleeding on probing, and plaque index were measured. The graft harvesting and recipient bed preparation method were similar in the two groups, and the only difference was the graft length. FGG was harvested with a length 40% shorter than the mesiodistal length of the recipient area in the accordion method and as much as the recipient area in the conventional method. vertical graft shrinkage 1, 3, and 6months following conventional graft placement was 12.04±14.99, 17.12±20.40, and 23.29±24.63 percent, respectively. In the accordion graft group, the shrinkage was significantly greater with 30.10±16.12, 36.99±15.51, and 43.75±18.78 percent at 1, 3, and 6months, respectively (p-value<.001). Other factors did not show a clinically significant difference between the two groups. Comparison of vertical shrinkage changes shows that the shrinkage rate in the accordion group is significantly higher than the conventional group. IRCT20190721044296N1 (Evaluation of dimensional changes of peri-implant attached mucosa following the treatment of free gingival graft by conventional and accordion methods; randomized clinical trial two-arm parallel).

Clinical Outcomes of Free Gingival Graft Following Recipient Bed Preparation with Er,Cr:YSGG Laser Versus Scalpel: A Split-Mouth Randomized Clinical Trial

Objective: Free gingival graft (FGG) procedure is accompanied with a considerable rate of graft shrinkage. This study was aimed to assess the dimensional changes of FGG after recipient site preparation with Er,Cr:YSGG laser and surgical scalpel. Materials and methods: This split-mouth randomized clinical trial evaluated 11 patients with bilateral lack of keratinized gingiva in mandibular premolars. The test side in each patient was prepared with Er,Cr:YSGG laser (3 W power, 300 mJ energy, 10 Hz frequency, long-pulsed mode), whereas the control side was prepared by surgical scalpel. All FGGs were harvested from the palate with standard dimensions of 14 × 9 mm. The graft width, length, surface area, and shrinkage and color match were measured after 1, 3, and 6 months. Postoperative complications, including pain and bleeding were also evaluated using a questionnaire. Results: In both groups, the surface area and width of graft significantly decreased at all time points compared with baseline but the difference in this respect was not significant between the two groups (p > 0.05). In both groups, maximum shrinkage occurred within the first 3 months. In control group, the surface shrinkage in 3 months was significantly greater than the first month (p = 0.025) without significant difference between groups (p = 0.79). The two groups were not significantly different regarding pain score and bleeding score either. On the day of surgery, the test group had slightly lower pain score and higher bleeding score in comparison to the control group without significant difference. The pain and bleeding scores reduced in both groups with no significant difference (p > 0.05). Conclusions: Er,Cr:YSGG laser has promising results for preparation of FGG recipient site and yields results comparable to those of surgical scalpel.

Microskin grafting: clinical study of its feasibility and results

Split-thickness autografts offer the best form of wound coverage, but limited donor sites and donor site related morbidity have resulted in the search for alternatives in the form of microskin graft. Twenty-five consecutive patients with post burn, post traumatic, and post cellulitis raw area were included in this study. After appropriate preparation of recipient bed, microskin graft was applied under general/regional anaesthesia. The assessment of microskin graft was done clinically on 5th, 7th, 10th, and 14th days and until the wound healed. Percentage of microskin graft take/loss, presence of infection, and duration of wound healing were noted. Complete wound healing was considered the endpoint of the study. Late assessment was done at 3 and 6 months postoperative to assess the scar. There were 19 male and 6 female patients with mean age of 27.52 years (range 18–54 years). Mean size of wound was 337.48 cm2 (range 120–770 cm2). All wounds healed in ~ 17.28 days without the need of secondary skin grafting. There was no clinically evident infection in the grafted wounds. Overall graft survival rate was ~ 94.76%. After 2 months, homogenous scar was present but there was hypo-pigmentation in 4 cases. There was no hypertrophy or scar contracture at 6 months. Micrografting is a feasible alternative for wound coverage and a useful tool for surgeons when donor sites are limited. Level of evidence: Level IV, therapeutic study.

Advanced Aesthetic Facial Rejuvenation: Sculptural Fat Restoration by Autologous Fat Transfer with Adipose-Derived Stem Cell Therapy

Introduction: The aging process uniquely challenges facial aesthetics by inherent variable soft-tissue and structural remodeling. Rejuvenation of the aging face by autologous fat transfer (AFT) enriched with adipose-derived stem cells (ADSCs) remains a treatment option for volume restoration and contour deficiencies, establishing facial harmony and beauty. Successful outcomes incorporate artistic principles and sound fat-grafting techniques. Materials and Methods: The author presents a review of current scientific PubMed literature and sculptural resources on facial aging, aesthetics, and autologous fat and stem cell grafting and describes advanced fat-grafting techniques for facial rejuvenation. Results: Improved clinical fat graft survivability and aesthetic outcomes have been observed in 50 patients treated by the proposed techniques of autologous fat graft and stem cell recipient bed preparation administered by sculptural fat transplantation. Conclusions: Sculptural fat restoration integrated with AFT and selective ADSC seeding is an important key to facial rejuvenation, producing aesthetically pleasing and lasting results.

External Volume Expansion Increases Subcutaneous Thickness, Cell Proliferation, and Vascular Remodeling in a Murine Model

Fat grafting is a powerful tool for soft-tissue reconstruction; however, the science behind recipient bed preparation has not been thoroughly explored. External volume expansion using suction before fat grafting has been used clinically to improve reliability and consistency of graft survival. The authors developed a murine model to investigate the underlying mechanism of external volume expansion. The authors created an external volume expansion device using a soft-silicone dome connected to a vacuum source (25 mmHg) to treat the dorsum of mice, and the response was compared with treatment with an occlusive dressing. Treated areas were monitored with magnetic resonance imaging. Remodeling of microvasculature was studied with corrosion casting on day 7. Effects on tissue thickness, number of adipocytes, cell proliferation, and blood vessel density were analyzed at 28 days. Macroscopic analysis showed tissue swelling at sites treated with the external volume expansion device by 21 days, without skin damage. On day 28, external volume expansion increased the thickness of the subcutaneous fat layer twofold, consistent with magnetic resonance imaging observations. The proliferation rate in the subcutaneous layer of expansion-treated areas increased twofold, with a net 2.2-fold increase in number of adipocytes in columns; remodeling of the vessels network occurred, with reorientation and increase of vessel diameters shown by corrosion casting and 1.9-fold augmentation of vessels density. External volume expansion applied to mouse integument induces highly proliferative and vascularized subcutaneous tissue. Recipient-site preparation using external volume expansion devices may be a promising tool to enhance cell and tissue engraftment.

Root Coverage with a Free Gingival Autograft using an Er, Cr: YSGG Laser

The mucogingival problems encountered, are addressed by various periodontal plastic surgical procedures one of which is the free gingival autograft. Grafting procedures can be performed traditionally by use of a scalpel or by the use of lasers. A case of gingival recession with a shallow vestibule, treated with a free gingival graft using an Er, Cr: YSGG laser with a wavelength of 2780 nm is presented here. The objective was to achieve complete root coverage with increased width of attached gingiva in relation to 31 and 41. The recipient bed preparation and harvesting of graft from donor site were done with the Er, Cr: YSGG laser using the appropriate laser parameters so as to ensure proper healing of the free gingival graft. The results showed uneventful healing of donor site with complete root coverage and increased width of attached gingival in the recipient site. The results of the therapy were assessed after 3 months.

Root coverage with a free gingival autograft using a diode laser

Gingival recession is a most common condition affecting the supporting structures of the teeth, in which the change in the position of the gingiva affects the esthetics and also hypersensitivity due to the exposure of the cementum. Coverage of denuded roots has become one of the most challenging procedures in periodontal mucogingival surgery. The principal objective in the treatment of gingival recession is to cover the exposed root surfaces to improve esthetics and to reduce hypersensitivity. Grafting procedures can be performed traditionally by use of a scalpel or by the use of lasers. A case of gingival recession with a shallow vestibule, treated with a free gingival autograft using a Diode laser is presented here. The recipient bed preparation and harvesting of graft from donor site were done with the Diode laser using the appropriate laser parameters so as to ensure proper healing of the free gingival graft. The results showed uneventful healing of donor site with complete root coverage and increased width of attached gingiva in the recipient site. The results of the therapy were assessed after 3 months.

Facial nerve reconstruction using a muscle flap following resection of parotid gland tumours with thorough recipient bed preparation

Recent innovations in facial nerve reconstruction procedures or 'restoration of facial expression', extremely important in patients' social activities, have provided some interesting findings. However, there has been little discussion of immediate facial nerve reconstruction following resection of a parotid carcinoma. In this article, details of our techniques and the concepts are presented. Ten patients underwent immediate facial nerve reconstruction following resection of a parotid carcinoma, with thorough 'recipient bed preparation', between October 2003 and October 2009. Postoperative radiotherapy was administered to seven cases, with an average radiation dosage of 55 Gy. Nerve reconstruction was performed using a sural nerve graft and either method 1, using a sternocleidomastoid and platysma muscle flap or method 2, using a pectoralis major muscle flap. Method 1 was used in six cases, and method 2 in four. Postoperative function was House Brackmann (HB) grade II in two cases, grade III in seven, grade IV in one and unassessable in one. Average Sunnybrook facial grading score was 50. No complications, such as contour deformity or Frey syndrome, were detected. We performed immediate facial nerve reconstruction following resection of parotid tumours with the emphasis on recipient bed preparation using a muscle flap, achieving the following objectives: (1) stable facial nerve reconstruction; (2) avoidance of contour deformity; and (3) prevention of Frey syndrome. We believe this is an extremely useful method, technically easy to perform and provides stable results.