39
Volume1 Issue4
|
S
upporting
Y
our
P
ractice
This articlewasoriginallycreated for
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ManagingPatients with
GINGIVAL
GRAFTFAILUREORLOSS
Oasis Point ofCare
As periodontists, we perform gingival augmentation
procedures regularly. On occasion, a treated patient
contacts their family dentist following this type of
procedurewith concerns about the surgical site. Family
dentists are also involved in follow-up care, sometimes
in the early stages of post-operative healing. The follow-
ing is intended to help guide the dentist through con-
cerns they or the patientmay have during a follow-up
visit.
Presentation
Population
•
Individualswitha recent historyof gingival augmentation surgery
•
Immunocompromisedpatients and thosewithdelayedwound
healingmaybeat higher risk
Signs
•
Dislodgedor removed surgical dressing
•
Rednessof surgical (recipient) siteor tissue sloughing
•
Approximatingvestibular tissuemayappear “necrotic”
•
Persistent root exposure likelynoted
Symptoms
•
Patientmayexperiencepain, describedas aconstant dull acheor
sharper painduringmasticationor speaking (movement of oral and
peri-oral tissues).
•
Patient experiences anxietyover procedureandperceived lackof
success.
Investigation
1.
Performcompleteextraoral (headandneck) and intraoral (teeth
and soft tissue) exams to ruleout postoperative infection. Evidence
of postoperativepain, bruising, swellingor even infectiondoesnot
indicateagingival graft failure/loss.
2.
Examine the surgical site:
•
Is thereevidenceof tissueon theperiodontal dressing?
•
Is there trauma to the siteas reportedbypatient?
•
Is thereevidenceof new tissuecovering theperiosteum, apical to
the toothor teeth that received thegraft?
TerrieLogue
DDS,CertPerio,
MRCD(C)
Dr. Logue is an
assistant professor in the
department of dental
clinical sciences in
DalhousieUniversity’s
faculty of dentistry.
She alsomaintains a
periodontal practice
inDartmouth,Nova
Scotia.
The author has no
declared financial
interests.
This article has been peer
reviewed.
DentalEmergency
Scenario
