Report of a Gingival “Surgical Cyst” Developing Secondarily to a Subepithelial Connective Tissue Graft

Abstract

The subepithelial connective tissue graft is a valuable technique used to cover exposed root surfaces or to increase the zone of attached gingiva. Cysts, such as the gingival cyst of the adult, are epithelial-lined cysts which may arise from heterotropic glandular tissue, a proliferating rete peg, remnants of the dental lamina, or traumatic implantation of epithelial tissue. In this paper, a case report is described of a "surgical cyst" or cystic morphogenesis of surgically implanted epithelium developing secondarily to a subepithelial connective tissue graft.

Treatment of Multiple Areas of Gingival Recession Using a Simple Harvesting Technique for Autogenous Connective Tissue Graft

“…The presence of bleeding points should be a guide when deepithelializing the palate to ensure that the majority of the epithelium is removed. An important consideration is that a rare gingival “surgical cyst,” developing 15 months secondary to a subepithelial connective tissue graft, has been reported 26 . The clinical history and histologic characteristics of the reported cyst suggest inadvertent implantation of traumatized epithelium as the etiology of the lesion 26 .…”

“…An important consideration is that a rare gingival “surgical cyst,” developing 15 months secondary to a subepithelial connective tissue graft, has been reported 26 . The clinical history and histologic characteristics of the reported cyst suggest inadvertent implantation of traumatized epithelium as the etiology of the lesion 26 . Likewise, there was a report 27 of an epithelial inclusion cyst after a free gingival graft was used for gingival augmentation only.…”

Subepithelial Connective Tissue Graft for Root Coverage: A Case Report of an Unusual Late Complication of Epithelial Origin

“…Root resorption was reported as an incidental finding at 1 and 2 years after SCTG, 20,21 without any associated symptoms. Late cyst or cystlike formations, attributed to epithelial remnants being embedded under the overlying flap, were reported 13 to 15 months postoperatively 22,23 . A gingival cul‐de‐sac was reported 9 months after the root coverage procedure and 3 months after a subsequent gingivoplasty to reduce the bulkiness of the tissue 24 .…”

“…From a time perspective, the existing reports include early complications, occurring in the immediate postoperative period or within the first few weeks, such as the more common ones of pain, 16,17 hemorrhage, 16,17 and swelling, 16,17 and the rare ones of infection 16 and reaction to suture materials 18 . The reported late complications, manifesting anywhere between a few months and several years postoperatively, are all rare and include the development of exostosis, 19 root resorption, 20,21 cysts, 22,23 and cul‐de‐sac 24 …”

“…From an involved tissue or tissue of origin perspective, the reported late complications concern the alveolar bone, 19 the root surface/periodontal ligament, 20,21 and the gingival connective tissue/gingival epithelium 22‐24 . The purpose of this article is to present a case of SCTG that developed an unusual late complication of apparent epithelial origin and to explore the possible relationship between this complication and the patient's skin health.…”