Clinical and morphological rationale for the use of a free split-thickness skin graft from the inner surface of the shoulder to form soft tissues when replacing dentition defects with dental implants

The need to create favorable conditions for the surrounding soft tissues to keep dental implants stable and functioning for a long time is currently well known. Often, in case of complete absence of teeth, it may be necessary to form a long and wide area of the keratinized tissue attachment. This requires a large amount of plastic material of appropriate quality, which can only be obtained from the extra-oral areas. Thus, the purpose and objective of this study was to determine a clinical and morphological substantiation of the use of a split-thickness skin graft from the inner surface of the shoulder (STSGiss) for peri-implant tissue grafting.
Material and methods. The study involved 12 patients aged 30 to 82 years with various defects and/or atrophy of the alveolar bone tissue in the upper and lower jaw in the period from 2016 to 2021. The formation of the attached keratinized gum was carried out with the help of STSGiss. Pathological assessment of the skin grafts and the native mucosa samples was performed.
Results. Pathological examination of the mucosa was carried out 18 months post transplantation. According to our data, STSGiss showed morphological signs of the attached oral mucosa, the epidermis was completely replaced by a multilayered squamous epithelium after 18 months. We can assume that the STSGiss morphological evolution depends on the thickness of the grafted split-thickness skin flap and the localization of the donor site.
Key words: split-thickness autograft, autotransplantation, soft tissues around the implants, keratinized gum, morphology
Conflicts of interest. The author have no conflicts of interest to declare.
Funding. There was no funding for this study