Surgical treatment of multiple gingival recessions by the combination of autograftand allogenic lyophilized dura mater: a clinical case

Relevance. Gingival recession is the apical migration of the gingival tissues associated with the exposure of the roots and alveolar bone loss. The prevalence of single recessions in people over 18 years old is 86.7% whereas multiple recessions, i.e. where all teeth are affected, amount up to 28.6%. High prevalence of the pathology necessitates improvement of the approach and tactic of multiple recession treatment in patients with different phenotypes. Nowadays, the use of autograft is the gold standard of multiple recession treatment. However, the technique has its drawbacks. The purpose of the present work was to assess the response to surgery and evaluate the final result of multiple recession treatment in one subject where the combination of autogenic and allogenic grafts was used in the same study design.Materials and methods. The paper presents and describes a clinical case where auto- and allografts were used in one patient to treat multiple gingival recessions.Results. All parameters of the gingival recession assessment showed comparable clinical benefit in all sites of autograft and allograft (dura mater) application. The root coverage was more than 80% around 13 teeth and less than 80% around 11 teeth.Conclusion. The results of the autograft and allograft (dura mater) application were comparable, response to surgery was the same; besides, the allograft (dura mater) is attractive for combined and independent use during surgical treatment of multiple and especially full-mouth recessions.

Preoperative Embolization of Intracranial Meningiomas

The operative and histopathological findings in 31 cases of intracranial meningioma after preoperative embolization with Gelfoam and/or lyophilized dura mater are reported. Removal of the tumor after embolization was facilitated in those meningiomas fed exclusively or mainly by branches of the external carotid artery (29 of 31). Large areas of tumor necrosis were never seen on histopathological examination, even when suggested by large regions of decreased density on the postembolization computed tomographic scan. Preoperative embolization of the feeding vessels arising from the external carotid artery system has proven to be a useful adjunct before the resection of intracranial meningiomas.