Hyperplastic Response Following Soft Tissue Augmentation in the Esthetic Zone

Clin Adv Periodontics. 2019 Jun;9(2):50-54. doi: 10.1002/cap.10047. Epub 2018 Nov 30.

Abstract

Introduction: The indications for augmentation of gingival tissue by connective tissue graft (CTG) are numerous. The techniques are widely adopted with extensive literature reporting high success. Harvest techniques include the mid to anterior palate, versus the posterior palate and tuberosity. The latter comprises denser collagen, identified as a more suitable graft. Alas, rarely have hyperplastic responses been reported.

Case presentation: Two adult, Caucasian patients presented with clinical need for soft tissue augmentation. Autogenous tissue was opted for, harvesting from the tuberosity gingiva. De-epithelialized outside the mouth and inserted into envelope flaps, late healing resulted in hyperplastic gingival lesions. Neither lesion could be successfully removed, and biopsy for histopathological investigation was carried out.

Conclusion: Hyperplastic response resulting from soft tissue augmentation with tuberosity CTG is rare but may occur. Laser or scalpel might not ensure complete removal. Informing the patient of this rare adverse effect may be important.

Keywords: Alveolar ridge augmentation; connective tissue; gingival hyperplasia; keloid; soft tissue neoplasms; transplants.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Collagen
  • Connective Tissue* / transplantation
  • Esthetics
  • Gingiva* / transplantation
  • Gingival Recession* / surgery
  • Humans
  • Palate

Substances

  • Collagen