Oral and Maxillofacial Surgery
Use of amnion as a graft material in vestibuloplasty: a preliminary report

https://doi.org/10.1016/j.tripleo.2003.10.031Get rights and content

Abstract

Objective

The aim of this study was to evaluate the clinical use of amnion as a biodegradable graft material for vestibuloplasty.

Study design

Seven subjects who had been referred for preprosthetic surgery underwent mandibular vestibuloplasty using Clark's technique and amnion as graft material. Fresh amniotic membrane was placed in the area and an acrylic splint was used with soft liner and 0.4-mm wires to cover the surgical site. The area was reexamined after 1 week, 2 weeks, 4 weeks, 3 months, and 6 months.

Results

A white necrotic soft tissue layer could be seen with underlying hyperemic tissue and an average reduction of 1 to 3 mm in the depth of the labial vestibule after a week. By the end of the second week, the necrotic layer had disappeared, leaving slightly hyperemic mucosal tissue under. By the third week, the graft area could be noticed but the amnion had completely degenerated and disappeared. After 4 weeks, the subjects could be referred for their prosthodontic treatment. The reduction in the depth of the buccal vestibule ranged from 17% to 40% after 6 months' follow-up.

Conclusion

Amnion might be used as a potential graft material for vestibuloplasty.

Section snippets

Subjects and methods

Seven subjects consisting of 4 women and 3 men (mean age = 63 years) with no known systemic disease who had been referred from the Department of Prosthodontics for mandibular vestibuloplasty took part in this study. The institutional review board of our institution approved this study. Informed consent was obtained before an oral and maxillofacial surgeon began the operation.

Fresh amniotic membrane was provided from healthy seronegative mothers who underwent caesarian section. Small clean

Results

Following the removal of the splint a week after the operation, a white necrotic soft tissue layer could be seen with underlying hyperemic tissue. An average reduction of 1 to 3 mm in the depth of the labial vestibule could be noted (Table I). By the end of the second week, the necrotic layer had disappeared, leaving slightly hyperemic mucosal tissue.

Three of our subjects did not return after the second week. A soft tissue layer similar to attached mucosa with the appropriate consistency was

Discussion

Amniotic membrane has unique properties including antiadhesive effects, bacteriostatic properties, wound protection, pain reduction, and epithelialization effects. Another characteristic of amniotic membrane is the lack of immunogenicity.15 Amniotic membrane has been used as a surgical material for several decades.16

There are only few reports in the literature on reconstruction of oral tissues using amnion. Lawson in 198517 studied the use of amniotic membrane along with pectoralis major muscle

Conclusion

The results generally show that amniotic membrane might be a favorable graft material for vestibuloplasty, promoting healing and preventing relapse. However, further study with larger samples and longer follow-up is certainly recommended.

References (27)

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This study was supported by the School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

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