Alloderm, an acellular dermal matrix originally used to cover burn wounds, is now being used in periodontal plastic procedures for root coverage. This exogenous tissue is considered advantageous because it eliminates the need to obtain a palatal connective tissue graft from the patient, resulting in less patient morbidity.
However, the research shows that for root coverage procedures, a connective tissue graft results in more keratinized tissue production and maintenance of the soft tissue thickness at the gingival margin as compared to Alloderm. Both procedures will show a similar amount of root coverage, bone regeneration, cementum, and biological width formation.*
Therefore, except when it is impossible to obtain a graft from the patient, I prefer to use a connective tissue graft rather than Alloderm. Microsurgery, as utilized in my practice, offers a clear advantage. With the increased magnification and illumination of the microscope, significantly smaller instruments and microsurgical techniques utilized to obtain a palatal connective tissue graft, the patient experiences little to no pain. Thus, the benefits of Alloderm from a patient and clinical result perspective do not apply in my practice.
Patients can have the best of both worlds. Using the knowledge I have acquired in microsurgery, I can now regenerate the maximum amount of keratinized tissue, create a thicker tissue at the gingival margin and causing little to no discomfort while using the patient’s own tissue.
*Clinical and Histological Evaluation of an Acellular Dermal Matrix Allograft in Combination with a Coronally Advanced Flap in the Treatment of Miller Class I Recession Defects: JClinPerio2009-Nunez, J
