Leczenie implantoprotetyczne po urazie w strefie estetycznej
The use of socket seal technique, thanks to full thickness gingival grafts (FGG) from the palate, allows preserving the structure of alveolar process. When collecting the graft, attention must be paid to make incisions perpendicular to the surface of the tissues, while the graft itself has to be thick enough: the periostium must remain on the bone. Graft stabilization is initially achieved using horizontal mattress sutures (with 6-0 or 7-0 thread). When tying off the suture, the thread must be tightened enough so that the graft lies tightly on the marginal gingiva surrounding the alveolar cavity after extraction. The wound is then closed using single sutures (6-0 or 7-0 thread) in order to obtain ideal initial adherence of soft tissues, to make the diffusion lines in the first day after the operation as short as possible. The described initial adherence of tissues is even more important for the success when the FGG graft is being placed on a barrier membrane. Then, the only source of nutrients for the transplanted tissue are the directly adjacent soft tissues in the recipient location. Still, there are cases where the source of nutrients is insufficient to maintain the integrity of the graft, leading to partial necrosis of the grafted tissue. A necrotic FGG graft turns white, the surface layers of tissue degenerate and peel off. Gradually, however, the peeled off necrotic tissue is replaced with fresh epithelium proliferating horizontally from the surrounding soft tissues. Under ideal conditions, this lateral migration of [...]
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