Free Gingival Graft Following Biopsy: A Case Report of Tissue Management

Abstract

Excisional biopsies require wide margins to facilitate removal of diseased tissue. Such margins often result in soft-tissue defects. These defects can cause reduced esthetics, ineffective oral hygiene performance, and postsurgical root sensitivity. This case documents the combination of two dental procedures: biopsy and the free gingival graft. A pyogenic granuloma, as diagnosed by histologic report, was removed by excisional biopsy and the resultant defect repaired by using a free gingival graft. Palatal tissue was grafted immediately to the site of the biopsy and sutured in place to cover the loss of attached tissue and papilla. At 6 months, the graft appeared to restore gingival health and maintain both esthetics and function in the surgical biopsy site. The patient was well served by correcting the resultant biopsy defect in a one-step procedure which encouraged healing and an excellent esthetic result.

Coverage Root after Removing Peripheral Ossifying Fibroma: 5-Year Follow-Up Case Report

“…This decision was made to avoid repetitious postoperative discomfort for the patient and to make oral hygiene procedures more effective in accordance with Anderegg and Metzler (1996) [14] and Keskiner et al (2016) [15]. …”

Periodontal Plastic Surgery Associated With Treatment for the Removal of Gingival Overgrowth

“…This persistence rate may be due to incomplete initial removal, as described in Case 1, which used a conservative gingivectomy technique in an attempt to preserve the esthetic harmony of gingival architecture. Therefore, a more aggressive approach is necessary to ensure the complete excision of the lesion, which frequently results in a mucogingival defect 11 . Periodontal plastic surgery techniques may be used to solve these functional and/or esthetic problems 4,10 …”

“…In the first clinical case presented in this report, the recurrence of the pyogenic granuloma after excisional biopsy by gingivectomy was probably attributable to the insufficient removal of gingival tissue due to concern with the final esthetic result. Hence, a more invasive procedure with a margin of safety was effected for the complete removal of the lesion 11 . Because the adjacent areas presented a wide band of attached gingiva, a lateral displacement of the flap with a submarginal incision, as described by Grupe, 28 was performed, reconstituting the excised gingival tissue.…”

“…In 1975, Vogan 10 described two clinical cases of pyogenic granuloma removal using a laterally positioned flap in an attempt to minimize or eliminate postoperative periodontal problems and, consequently, the need for the patient to undergo a subsequent repair procedure. In 1996, Anderegg and Metzler 11 suggested, during the lesion excision, the combination of two dental procedures, biopsy and the free gingival graft, which encouraged healing and an excellent esthetic result.…”

Esthetic management of gingival lesions in anterior maxilla: The role of VIP-CT Flap, a technical note

“…[2] Excisional biopsy of the pathology responsible for gingival overgrowth will lead to unsightly gingival defect. [3] Vascularized interpositional periosteal connective tissue flap (VIP-CT) is introduced for reconstruction of the lost tissues in such situations.…”