Thesis (Ph.D.) - Cairo University - Faculty of Oral and dental medicine - Department of Periodontology

evaluation the soft tissue biotype, soft tissue profile, volume stability and profile after augmentation using partially de-epithelized connective tissue graft versus Mucograft® in single missing tooth site with defective ridge site as a pre-prosthetic treatment to obtain maximum aesthetics and mimic natural ridge relation with pontic site. Methodology: a total of 32 patients received pre-prosthetic reconstructive surgeries to treat the defect at the pontic site using the Mucograft® in 16 patients and the partially de-epithelised graft in the rest of the participants. The partially de-epithelized graft was marked on the palate to the needed size then epithelization was made while the graft is inset using wheel stone. The changes in the keratinized tissue width were measured at 1, 3 and 6 months thickness clinically and volumetric changes by 3D analysis using Superimposition of optically scanned dental cast for baseline and after 6 months. Temporary restorations were fabricated at 3 months and final fixed zirconia bridges delivered at the 6 months postoperatively and the pink aesthetic score was assessed by two reviewers . Results: In the Mucograft® group there was increase in the measured clinical parameters of keratinized Tissue (KTW) width with mean value 5.9±2.08mm compared to the KTW the partially de-epithelized which was 5.73±0.647 with no statistical significant difference. The KTT was compared at different tissue levels. KTT of Mucograft® in crestal (1.82±0.6) and buccal at 2mm,4mm and 6mm (2.91±0.7, 2.73±0.45 and 0.18±0.4) respectively while the KTT of the partially de-epithelized at crestal area 3.05±0.65 and also at 2,4and 6mm were 2.77±0.68, 2.41±0.63, 1.77±0.52 respectively. The statistical significance was observed at the crestal and 6mm apical levels with no statistical significant at 2 and 4mm apical levels. Volumetric gain of Mucograft and partially de-epithelized graft was 115.26 ±44.48, 209.9± 74.45 mm³ respectively with statistical significant increase at partially de-epithelized graft group. PES score and PSPSQ show no statistical significance difference between the Mucograft and partially de-epithelized graft.Conclusions: Both Grafts increase the KTW, KTT and the total volume of Defective alveolar ridge compared to its baseline measurements, with more volumetric gain was found in partially de-epithelized graft

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