implants UK - the journal of oral implantology

32 I I clinical _ ridge augmentation implants1_2011 AlloDerm: Ridge Augmentation of Dental Implant SitesAuthor_ Dr Amit Patel _Dental aesthetics has now become a key issue in implant dentistry. This importance of dental aesthetics means that the quality and quantity of the sort-tissue surrounding the implant, is as important as the final restoration. The bone volume of an implant site, both im- plants buccolingually and apicocoronally, can affecttheimplant’sfinalpositionandthustheaes- thetics final restoration. It is suggested, especially in the aesthetic zone, that the minimum amount of buccal bone should be at least two mm from the implant shoulder. Deficiencies in bone and tissue volume often require augmentation, such as guided bone regeneration (GBR). This technique can increase the buccal bone volume, to at least two-three mm, so long lasting support for the buc- cal tissues is achieved. It is also possible to improve the appearance of soft tissue by placing a soft tissue graft simultane- ously with GBR Patients who have a thin biotype can be modified to a thicker biotype by placing a connective tissue graft under the buccal flap. Harvesting a connective tissue graft from the palate can be difficult due to the large number of factors involved: the shape of the palatal vault; position of the palatal artery; the amount of con- nective tissue needed for the primary site; and the amount of adipose tissue on the graft. Connective tissue grafts also involve two surgical sites for the patient, doubling the possibility of poor healing. AlloDerm is used as an alternative to connective tissue grafts, it eliminates the need for a second surgical site. AlloDerm is an acellular dermal ma- trix allograft; a product that was originally used in burns surgery. It is highly processed de-epitheli- alised human skin dermal allograft composed of a basement membrane and an extracellular matrix with collagen bundles and elastin fibres. AlloDerm Fig. 1_: LL6 site showing a reduced amount of keratinised tissue. Fig. 2_: Gingival tissue at three months after implant placement. Note the increase in gingival volume. Fig. 1 Fig. 2