Tunnel connective tissue graft

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Tunnel connective tissue graft options

Tunnel connective tissue grafts are becoming more common and the steps and techniques may vary from clinician to clinician.

Pedicle tunnel connective tissue graft

The pedicle tunnel connective tissue graft is a nice trick for anterior soft tissue grafting. A vascularized interpositional periosteal (VIP) connective tissue graft and interpositional vascularized augmentation neogenesis (IVAN – Pohl JOI 2020) are other common names. This can be useful in Seibert Class III defects as seen in Ferreira JOI 2018.

 

Modified rolled pedicle graft

This grafting technique can be a standard graft for any edentulous anterior area either at placement or uncovery or both. Bassam has a nice article on this technique.

Rolled pedicle connective tissue graft for implant placement

Modified tunnel technique

Some tips for the modified tunnel technique

  • Use a connective tissue graft of adequate thickness, which is 1-1.5mm.
  • Temporarily bond the contacts points together to help with the suturing.

 

VISTA = Vertical Incision Subperiosteal Tunnel Access

Technique used for grafting anterior.  Can be used for bone grafting pre-implant surgery or recession.

There is video of using SECTG and some alloderm? This would be one option for treating cervical lesions and/or recession in the anterior.

Could also use with sticky bone in anterior to bulk out facial which would be especially useful if doing immediate implant.

Some using PRF slugs to reduce secondary surgical site as well. Liang JOI 2023 shows a tunneling technique for GBR.