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Perio - Periodontal Practices Today

Year 2008
Volume 5 , Issue 4

Pages: 231 - 240

Haemorrhagic risk when harvesting palatal connective tissue grafts: a reality?

Dridi, Sophie-Myriam / Chousterman, Michel / Danan, Marc / Gaudy, Jean Francois

When obtaining good clinical results using connective tissue submerged grafts, the vast majority of authors place great emphasis on the surgical techniques carried out. However, few studies have shown the complications that may arise during such interventions. Although complications may not be frequent and are not life-threatening, these complications do exist. These complications generate anxiety for practitioners. Those that are regarded with most apprehension are peri- and post-operative haemorrhage, and this occurs due to the physiological vascularisation density of the palatal mucosa. Through a study of the human anatomy, the authors verified the correlations that could exist between the morphology of the hard palate and the distribution of the greater palatine pedicle and, furthermore, if they were determining factors in choosing therapeutic options. This study comprises two sections relating to applied anatomy: osteology (part 1) and dissection (part 2). Part 1 involved 30 maxillas presenting various forms and edentitions. Observations were carried out to compare the relationship between the line of the greater palatine pedicle, the morphology of the palate, and the effects of osseous remodelling associated with extractions and the installation of removable prosthesis. Part 2 was carried out on 12 fresh human cadaver maxillas. After injection of the arterial system with coloured latex, the specimens were dissected to observe the distribution of the greater palatine pedicle of the palate. Anatomical surgery was carried out on two palates with different morphologies and different tissue harvesting techniques were performed. This allowed the authors to first specify the vascular distribution pattern of the palate, and to evaluate the relation between the sample zones and the branches of the greater palatine pedicle, to finally establish rules to help prevent haemorrhage from occurring. Keywords: connective tissue graft, haemorrhagic risk, human hard palate, palatine artery


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