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Gum Diseases

Donor Graft Complication

05/24/2010

Question:

I had a donor gum graft performed on the molars just in front of my back upper molars a week ago (Friday). I`m happy not to have a wound in the roof my mouth but I`m surprised and worried (freaked out is more like it) about what is happening.

Two days later (Sunday) gray-green tissue came off from both areas. I wasn`t concerned at the time and continued to follow the post operative instructions to not take a peak. On the morning of the fourth day my cheeks were more swollen than they had been before especially on the left so I called the dental office and was provided an antibiotic. The swelling went down within 12 hours.

Yesterday (Thursday) when I was eating my pasta lunch the tissue on the right side came lose and started flapping around in my mouth. I called the dental office right away and they told me to be careful until I came in the next day (Friday). I peaked and noticed white (I think that is the donor tissue) all the way up to the fold where the gum and cheek meets.

This morning (Friday) I heard the periodontist note there has been significant sloughing of the gum tissue on the left side leaving little tissue. She sewed down the flap and sent me on my way with instructions to keep my tongue off and not to peak. We rescheduled a followup in three weeks.

Keeping my tongue off has been difficult, last time it strayed up there I felt soft wrinkly tissue in the fold of my cheek and gum creeping on to my cheek, the same sensation of I felt right before the tissue came off on day Sunday.

I`m terrified something is very wrong. Should I be worried or is this a `normal` complication and I should just continue to wait and watch.

Thank you for your time and expertise.

Answer:

I am assuming that Alloderm was purchased and placed instead of your own gum tissue. The major complication with Alloderm is that when the patient has very limited amount of gum to start with it is very hard to cover this material with patient's own tissue (flap). Then it becomes exposed and most of it will reabsorb really fast. I think that this is what is happening. I may be wrong since I do not have a chance to see you.

 

Your periodontist will wait until your soft tissue heals and has to decide whether she can repeat this procedure or use your own gums from your palate. However, she has to wait until soft tissue is mature enough.

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Response by:

Binnaz   Leblebicioglu, DDS, MS, PhD Binnaz Leblebicioglu, DDS, MS, PhD
Associate Professor of Periodontology
College of Dentistry
The Ohio State University