The Alloderm Reverse Tunneling (ART) technique represents a combination of key features contained within the previously described gingival grafting protocols. Several highlights of this proprietary technique are outlined as follows:
1) Application of Platelet Rich Plasma (partitioned blood containing patient-derived growth factors) to facilitate wound healing, enhance graft/flap stabilization, and improve recovery times with minimal post-operative symptomology.
2) Simplified surgical armamentarium consisting mainly of a Curved/Flexible Blade, Double End Titanium Nitride Composite Instrument or equivalent for tunneling (11mm long/1.8mm wide working blade), SUB-O gracey curette or equivalent for advancing the tunnel, UNC-15 periodontal probe to verify dissection and continuity of the pouch, and a Castro Viejo needle holder for suturing.
3) Bi-directional tunneling of the gingival tissues to improve tunnel creation, tissue mobility, and graft insertion while minimizing nicks, tears, and perforations to the free gingival margins, gingival vent entry points in the alveolar mucosa, and overlying native tissues. The term “reverse” tunneling implies performing the flap dissection in the opposite direction, in the context that it is either being compared to sulcular or vestibular tunneling methods.
4) Maximum access to the sub-gingival environment through multiple entry points which allows for optimal navigation through challenging biotypes, non-uniform bony architecture, and around anatomical limitations within the surgical region.
5) Ease of insertion of the grafting material (Alloderm, Lifecell) via suture anchoring to the graft material, sulcular threading of the suture, and graft advancement by way of the suture leading the Alloderm through the tunneled preparation. A single papilla may be incised at the furthest point of the surgical region in order to accommodate the width component of the graft through the first gingival sulcus.
Center for Periodontics & Implant Dentistry
www.cpi-dent.com (847) 818-9950