Creeping Clinical Attachment After Acellular Dermal Matrix Augmentation to Attain Root Coverage.

INTRODUCTION: This case report documents root coverage after using an acellular dermal matrix (ADM) combined with a tunneling procedure. The photographs and objective clinical measurements are presented to document a gain of new clinical attachment and subsequent creeping attachment. CASE PRESENTATION: A 50-year-old male who demonstrated around 6 mm of recessions on the direct facial of teeth #6 through #11 had a root coverage procedure using an ADM. After 24 months, >90% of the recession defects at all sites were eliminated. It was noted that creeping clinical attachment began to appear 6 months after initial therapy on teeth #7 through# 11. CONCLUSION: The delayed creeping attachment seems to be due to the time necessary to vascularize the ADM and the rate of vascularization may vary with different thicknesses of inserted ADM.

Cytocone Procedure: Conservative Repair of a Buccal Plate Dehiscence in Preparation for Implant Placement.

In type II sockets, the soft-tissue level is at or coronal to the cementoenamel junction, and part of the buccal plate is missing. In the esthetic zone, a patient with this type of situation often is not a good candidate for immediate implant placement until the osseous defect is repaired. Therefore, use of a conservative regenerative procedure to repair such a defective socket would be advantageous. The Cytocone procedure utilizes a nonresorbable dense polytetrafluorethylene (d-PTFE) barrier and modifies the classic "ice cream cone" technique to restore a buccal osseous defect without raising a labial flap. This article describes and illustrates the Cytocone procedure.