Palatal Tissue Enlargement After Subepithelial Connective Tissue Graft Harvest Associated With Anabolic Steroid Abuse.

INTRODUCTION: Healing complications associated with androgenic anabolic steroid (AAS) abuse have received minimal attention in the periodontal literature. This case report describes an adverse healing event after palatal subepithelial connective tissue graft (SECTG) harvest associated with AAS abuse. CASE PRESENTATION: A 35-year-old white male was treated with an SECTG procedure to address gingival recession on the facial aspect of teeth #24 and #25. Donor tissue was harvested from the left hard palate via a single incision technique. The procedure was completed without complication. One week postoperatively, the patient presented with a large asymptomatic overgrowth of tissue from the palatal harvest site. Over the following 5 weeks of continued observation, the lesion demonstrated progressive, spontaneous resolution. Investigation of possible etiology revealed the subject was a recreational bodybuilder with admitted AAS abuse. CONCLUSIONS: Post-surgical healing can be influenced by AAS abuse. Alterations in connective tissue metabolism and fibroblast activity are known sequelae of AAS abuse; however, patients may be reluctant to admit to steroid abuse during the presurgical interview. Surgeons should suspect the possibility of AAS abuse when postoperative complications present in a patient of muscular body type.

Surgical considerations and management of patients with mucocutaneous disorders.

Surgeons may be confronted with providing periodontal plastic or implant therapy for patients with gingival manifestations of systemic conditions. These conditions (often referred to as mucocutaneous disorders) commonly present with features of desquamative gingivitis, which was once believed to represent a disease entity. However, today, the term desquamative gingivitis is used to describe clinical features of various local or systemic diseases or disorders that result in chronic gingival lesions characterized by epithelial desquamation, erythema, ulceration, and/or vesiculobullous lesions of the gingiva. Often, other oral tissues also are involved. Mucocutaneous disorders include such disease entities as lichen planus, graft-versus-host disease, pemphigoid, pemphigus vulgaris, lupus erythematosus, erythema multiforme, and linear IgA disease. Surgeons should be able to recognize these disorders and have the tools necessary to treat these conditions so that they can render the appropriate surgical care. This article describes the diagnosis, etiology, and clinical manifestation of these disease entities, as well as the surgical considerations and management in providing care to these patients.

Periodontal and periimplant maintenance: a critical factor in long-term treatment success.

Periodontal maintenance (PM) is a critical factor in the long-term success of both periodontal and dental implant therapy. Studies have shown both modern periodontal and dental implant therapies are effective in maintaining natural teeth and replacing lost teeth, respectively. However, without a regular program of clinical reevaluation, plaque control, oral hygiene instruction, and reassessment of biomechanical factors, the benefits of treatment often are lost and inflammatory disease in the form of recurrent periodontitis or periimplantitis may result. This article reviews the goals, types, and appropriate frequency of PM in periodontal and dental implant therapy, as well as the incidence and etiology of periimplant disease and strategies for management when recurrent disease develops during the maintenance phase of treatment.