Combining Strip Gingival Grafting with Acellular Dermal Matrix

In an effort to address the challenges posed by insufficient keratinized tissue around dental implants, Dr. Priscilla Sosa, a Periodontology resident at the University of Alabama in Birmingham School of Dentistry, has conducted pioneering research on the efficacy of soft tissue grafting techniques to improve patient outcomes. Recognizing the crucial role of keratinized tissue in protecting teeth and implants from bacterial invasion and promoting long-term stability, Dr. Sosa’s research provides valuable insights into how grafts can be used to enhance oral health in patients with soft tissue deficiencies.

“The importance of keratinized mucosa around implants is well-established for long-term implant success, stability, and patient comfort. However, current techniques often require trade-offs between esthetics, patient satisfaction, patient discomfort, and healing outcomes.” Dr. Sosa credits a 2015 prospective case series as the concept for her current research. The case series examined the efficacy of a combination of techniques in treating severe mucogingival effects – the strip gingival graft and the xenograft. “I was motivated to explore a novel combination of strip gingival graft (SGG) and acellular dermal matrix (ADM) to see if this approach could enhance both functional and esthetic outcomes while minimizing patient discomfort.”

The present goals of Dr. Sosa’s research balance clinical techniques with patient satisfaction. “Several surgical techniques have been described to increase keratinized tissue around implants and teeth. Despite various methods, the bulk of evidence reported that the use of keratinized autogenous graft (i.e., free gingival grafts (FGG)), harvested from the patient’s palate, remained the gold standard in soft tissue augmentation procedures and provided more predictable results. However, soft tissue autograft supply can be limited, and its harvesting is associated with increased patient morbidity. Several clinical studies have demonstrated the effectiveness of using allogenic soft tissue grafts such as Acellular Dermal Matrix Allograft (ADMA) instead of FGG to augment keratinized tissue.” She describes her research as bridging a gap between multiple complex facets of dentistry: tissue health surrounding implants, esthetic outcomes, and patient satisfaction. Through this combination of perspectives, Dr. Sosa expects future treatments to align more closely with patient expectations and steer the field toward patient-centered outcomes.

When asked about the future of her research area, Dr. Sosa anticipates a growing emphasis on patient-centered research. For example, she predicts grafting techniques becoming simultaneously more integrative, more refined, and less invasive. “Innovations in biomaterials and graft substitutes will likely improve outcomes further. Additionally, the role of digital technologies, such as intraoral scanning and 3D imaging, will continue to enhance treatment planning and follow-up care.”

On the topic of advice for prospective student researchers, Dr. Sosa suggested a couple different approaches. She suggests collaborating with experienced mentors to refine a research idea into a clinically relevant question which addresses a specific need or gap in knowledge. Additionally, staying current with scientific literature and emerging technologies are critical in developing innovative clinical solutions. Finally, Dr. Sosa emphasized the central role that patients play in dentistry. She says students should focus on “learning to manage patient interactions effectively, as patient satisfaction plays a critical role in the success of periodontal treatments.”