Pseudoaneurysm of the Greater Palatine Artery Following Autogenous Connective Tissue Gingival Graft : A Case Series

NCT03454490 — Unknown, 10 participants, Hopital de l'Enfant-Jesus

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RegistryNCT03454490
StatusUnknown
Study typeObservational
Enrollment10 (Estimated)
SponsorHopital de l'Enfant-Jesus (Other)
ConditionsPseudoaneurysm
InterventionsPostoperative pseudoaneurysm of the greater palatine artery (Procedure)
Datesstart 2018-03-01 (estimated), primary completion 2018-07-01 (estimated), completion 2018-07-01 (estimated), first posted 2018-03-06, last updated 2018-03-06

Related Papers Related Patents Related Grants Related Experts
All trials for Pseudoaneurysm All trials of Postoperative pseudoaneurysm of the greater palatine artery

-Summary

Gingival recession is defined as the apical migration of the gingival margin from the amelocemental junction. This condition may be associated with symptoms such as tooth hypersensitivity, root decay, and cosmetic complaints from patients. Many treatments have been used to treat gingival recession and the gold standard is the autogenous connective tissue gingival graft because of its predictability. This type of gingival graft is performed by harvesting connective tissue from patients' hard palate. Periodontists and general dentists frequently perform these gingival grafts. Occasionally, some patients develop postoperative complications that need to be addressed in an hospital setting. An uncommon but concerning complication of an autogenous connective tissue gingival graft is a donor site pseudoaneurysm of the greater palatine artery. No description of this complication following a gingival graft has been identified in the current literature. One case report mentioned that pseudoaneurysm of the greater palatine artery looks like a pulsatile nodule associated or not with pain on palpation. From the experience of the investigators, patients may consult an hospital setting having a complaint of major oral bleeding. Local hemostatic agents can palliate this type of bleeding, but angiographic embolization is often required. Several cases were treated in the investigators' hospital. Thus, the investigators believe it is relevant to share this experience with the scientific community. The primary objective of this case series is to inform dental professionals of the existence and the management of postoperative pseudoaneurysm of the greater palatine artery following autogenous gingival graft. The secondary objective is to find potential solutions to minimize the incidence of this morbid complication.

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+Arms and interventions

  • Postoperative pseudoaneurysm of the greater palatine artery (Procedure): Patients had an autogenous connective tissue gingival graft.

+Outcome measures

Primary outcomes

  • Postoperative oral bleeding [One month following autogenous connective tissue gingival graft]: Complication following autogenous connective tissue gingival graft

Secondary outcomes

  • Use of local hemostatic agents [Six months]: Palliative method before definitive care
  • Secondary effects following angiographic intervention [Six months]: Postoperative infection, bone or gum necrosis, extrusion of embolization material, loss of tooth, tooth devitalization following angiographic intervention
  • Number of followups required [Six months]: Secondary effects following angiographic intervention

+Eligibility

Sex: All

Inclusion Criteria:

* Population : Patients having a diagnostic of pseudoaneurysm of the greater palatine artery who had an autogenous connective tissue gingival graft
* Intervention : Patients treated with local hemostatic agents or by angiographic embolization
* Comparison : None

Exclusion Criteria:

* Missing data in patients' chart precluding complete data extraction

+Publications

  • Yadav AP, Kulloli A, Shetty S, Ligade SS, Martande SS, Gholkar MJ. Sub-epithelial connective tissue graft for the management of Miller's class I and class II isolated gingival recession defect: A systematic review of the factors influencing the outcome. J Investig Clin Dent. 2018 Aug;9(3):e12325. doi: 10.1111/jicd.12325. Epub 2018 Feb 9. PMID 29424485
  • Tozum TF, Keceli HG, Guncu GN, Hatipoglu H, Sengun D. Treatment of gingival recession: comparison of two techniques of subepithelial connective tissue graft. J Periodontol. 2005 Nov;76(11):1842-8. doi: 10.1902/jop.2005.76.11.1842. PMID 16274302
  • Byun HY, Oh TJ, Abuhussein HM, Yamashita J, Soehren SE, Wang HL. Significance of the epithelial collar on the subepithelial connective tissue graft. J Periodontol. 2009 Jun;80(6):924-32. doi: 10.1902/jop.2009.080673. PMID 19485822
  • Thomas J, Patel NS, Viroslav A, Sheykholeslami K. Greater palatine artery pseudoaneurysm presenting as a slow-growing palatal mass. J Oral Maxillofac Surg. 2013 Apr;71(4):e164-7. doi: 10.1016/j.joms.2012.11.017. Epub 2013 Jan 29. No abstract available. PMID 23375075

+Investigators