Published in April 1987
Blending of free gingival graft and protection of donor site with fibrin glue
GUSTAVO PETTI
Physician and Surgeon specializing in Dentistry. Periodontist.
Piazza Repubblica 4, 09129 Cagliari, Italy.
tel ++39 070 498159, fax ++39 070 400164
web site www.gustavopetti.it

Key words:

Blending - receiving bed - donor site - fibrin glue

 SUMMARY
The author focuses his attention on the careful finishing of the receiving bed of a free implant to achieve the most favourable morphologic adaptation of the implant on a specific suture, so as to stabilize it in the current unfavourable anatomic situation, and then on protection of the vast donor site with properly prepared fibrin glue.  
Fig. 1 Insufficient adhering gum
Fig. 2 Receiving bed is prepared by thinning the periosteum by chamfering the margins of the bed and scarifying the gum adhering mesio-coronal-distally to the bed itself.
Fig. 4 Graft is test-placed on receiving bed
Fig. 3 Graft is taken.
Fig. 6 The fibrin glue is prepared: it is reconstituted with one solution of freeze-dried Tissucol containing fibrinogen and Factor XIII and a solution of Aprotininia and another of freeze-dried bovine thrombin with a solution of calcium chloride at a concentration of 500 I.U./ml. The two solutions thus prepared are sucked into two separate syringes. These are then inserted into a two-way syringe, thus allowing the two solutions to blend and form fibrin glue on coming out of the needle.
Fig. 5 It is sutured with single stitches and an apical subperiosteal cross stitch penetrating through the compact tissues of the gum distally adhering to 3.4 in the vestibular-lingual direction and emerging mesially at 3.3 in the lingual vestibular direction and is then tied to the graft.
Fig. 7 A thin layer of Tissucol is deposited on the donor site. Fig. 8 After five months the cure is at its best.
Fig. 9 Appearance of graft following removal of the second pack on day fifteen.
Fig. l0 After five months the blending of the graft is quite good (Anglo-Saxon authors thus define all factors that influence the morphological adaptation of the graft).
References

CIANCAGLINl R.: "Adattamento morfofunzionale" degli autoinnesti gengivali "Atti del II Convegno S.I.d.P. di Firenze abstr. n. 4, Marzo,50-68, 1983.
COTTI S., PETTI G., PES I.: "Gli innesti liberi di gengiva in terapia parodontale", Rassegna medica Sarda, fasc. LXXX, 1-5, 1977.
PETTI G.: "Autoinnesto libero di gengiva con tessuto connettivo e protezione della zona donatrice con lembo a spessore parziale", II Dentista Moderno, 6, 1077-l080, 1986.
SCHLUNGER S., YOUDELIS R.A., PAGE R.C.: "La malattia parodontale, fenomeni basilari, terapia e correlazioni con i problemi occlusali e resaurativi", Piccin, 610-619, 1985.
SULLIVAN H.C., ATKINS J.H.: "Free autogenous gingival grafts. I. Principles of succesful grafting", Periodontics, 6, 121, I968.