Management of localized buccal dehiscence defect with allografts and acellular dermal matrix

This case series presents the use of acellular dermal matrix (ADM) as a barrier membrane in reconstructing non-spacemaking buccal dehiscences associated with simultaneous implant placement in locally deficient ridges. Five sites in four healthy nonsmoking patients were treated with a combination of the mucogingival pouch flap technique, sandwiched layering of mineralized human cancellous and cortical bone grafts, and ADM as a barrier membrane. Three sites encountered 2 to 4 mm of membrane exposure after 2 weeks of healing time. However, all sites were completely covered at 3 months. None of the cases exhibited implant exposure throughout the entire healing period. At the 6-month re-entry surgery, ADM-assisted guided bone regeneration achieved a mean of 86.5% height gain and critical bone thickness of 1.8 mm or greater, with clinical bone density equivalent to that of the native bone.