Management of hyperplastic tissue response following connective tissue grafting

IF 3.2 3区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Journal of Esthetic and Restorative Dentistry Pub Date : 2024-04-02 DOI:10.1111/jerd.13232
Snjezana Pohl MD, DDS, Howard Gluckman BDS, MChD, PhD
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Abstract

Objective

While connective tissue graft shrinkage is a well-documented post-transplantation reaction, there is a literature gap concerning hyperplastic tissue response. Despite its infrequent occurrence, investigation is warranted due to its capacity to compromise esthetics, disrupt lip dynamics, and promote food retention. Moreover, efforts to mitigate hyperplastic tissue response often prove challenging, and there is a potential risk of exacerbating gingival tissue rebound.

Clinical Considerations

This report presents a potential solution to managing tissue overgrowth after connective tissue grafting in five clinical cases. The patients underwent corrective surgery involving internal excision of excessive tissue while preserving the overlying mucosa. The surgical approach was tailored to excise hyperplastic tissue with minimal trauma, aiming to optimize esthetic outcomes. Subsequent follow-up assessments spanning 1–5 years demonstrated stable results, with no indications of relapse or recurrence of tissue overgrowth.

Conclusions

Within the limitations of this case series, surgical internal excision holds promise as a viable treatment modality for addressing post-transplantation hyperplastic tissue response.

Clinical Significance

This case series addresses the challenge of uncontrolled tissue overgrowth following connective tissue grafting, a concern for which previous attempts have proven unsuccessful. Internal in-toto excision emerges as a promising approach for effectively eliminating overgrown tissue, offering potential advancements in the clinical management of this complication.

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处理结缔组织移植后的增生组织反应。
目的:结缔组织移植后的萎缩是移植后反应的一种,但有关增生组织反应的文献资料尚缺。尽管增生组织反应并不常见,但由于它会影响美观、破坏唇部动态和促进食物滞留,因此有必要对其进行研究。此外,减轻增生组织反应的努力往往具有挑战性,而且存在加剧牙龈组织反弹的潜在风险:本报告在五个临床病例中介绍了处理结缔组织移植后组织过度生长的潜在解决方案。这些患者接受了矫正手术,包括内部切除过多的组织,同时保留上覆粘膜。手术方法是在最小创伤的情况下切除增生组织,以达到最佳的美学效果。随后1-5年的随访评估显示效果稳定,没有复发或组织过度生长复发的迹象:结论:在本系列病例的限制条件下,手术内切有望成为解决移植后增生组织反应的一种可行治疗方式:本系列病例解决了结缔组织移植后组织过度生长无法控制的难题,以往的尝试均未取得成功。内托切除术是一种有效消除过度生长组织的有前途的方法,为临床治疗这种并发症提供了潜在的进步。
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来源期刊
Journal of Esthetic and Restorative Dentistry
Journal of Esthetic and Restorative Dentistry 医学-牙科与口腔外科
CiteScore
6.30
自引率
6.20%
发文量
124
审稿时长
>12 weeks
期刊介绍: The Journal of Esthetic and Restorative Dentistry (JERD) is the longest standing peer-reviewed journal devoted solely to advancing the knowledge and practice of esthetic dentistry. Its goal is to provide the very latest evidence-based information in the realm of contemporary interdisciplinary esthetic dentistry through high quality clinical papers, sound research reports and educational features. The range of topics covered in the journal includes: - Interdisciplinary esthetic concepts - Implants - Conservative adhesive restorations - Tooth Whitening - Prosthodontic materials and techniques - Dental materials - Orthodontic, periodontal and endodontic esthetics - Esthetics related research - Innovations in esthetics
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