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| Title |
Amnion Chorion Membranes May Improve Palatal Donor Site Wound Healing for Autogenous Gingival Grafts |
| Clinical Question |
For patients receiving autogenous gingival grafts, would an amnion chorion membrane provide improved wound healing of the palatal donor site as compared to a hemostatic agent? |
| Clinical Bottom Line |
Amnion chorion membranes could potentially improve palatal donor site wound healing for autogenous gingival grafts in comparison to conventional post operative wound management strategies since they have shown successful outcomes in other periodontal and oral surgery procedures. This material has growth factors and other beneficial properties that could decrease healing time, improve post operative pain, and decrease the risk for infection for wounds in the mouth. More evidence is necessary on the effects of amnion chorion membranes for palatal donor site wound healing. |
| Best Evidence |
(you may view more info by clicking on the PubMed ID link) |
| PubMed ID |
Author / Year |
Patient Group |
Study type
(level of evidence) |
| #1) 33354857 | Gulameabasse/ 2021 | 21 studies/ 375 human subjects | Systematic review of non-randomized trials | | Key results | Many indications for the use and benefits of amnion chorion membranes in periodontal and oral surgery procedures were identified in this study, including a reduced risk of infection and inflammation in healing tissues. The many growth factors present in amnion chorion also promoted soft tissue vascularization, epithelialization, and regeneration, as well as bone regeneration. Reduced patient pain perception, rapid absorption, intimate adaptation, and a decreased need for suturing also provide benefits to using amnion chorion as an adjunctive therapy to periodontal and oral surgery procedures. | | #2) 33382524 | Yu/ 2022 | 3 Cases/ 3 Subjects/ 2 Middle-Aged Women | Case series | | Key results | Amnion chorion membranes improved wound healing of minimally traumatized gingival flaps that were closed with secondary intention during guided bone regeneration and ridge augmentation procedures. The many differing growth factors, cytokines, matrix proteins, and antimicrobial properties of amnion chorion promoted rapid epithelialization in these cases. | |
| Evidence Search |
Gingival graft amnion chorion AND wound healing amnion chorion |
Comments on
The Evidence |
The Gulameabasse review used the MEDLINE and Scopus databases to search articles published before July 2019 regarding the use of collagen or amnion chorion membranes in tissue regeneration studies on humans. The references of included articles were examined, and other pertinent studies were also included. Prospective, retrospective, and case series studies were included, the majority of which were randomized controlled trials, therefore moderate evidence was used for this review. Only 10 out of the 21 included studies used amnion chorion membranes. These studies have differing methods of membrane preservation, flap design, and treatment choice, including periodontal surgery, implant and periimplant surgery, and bone reconstruction, therefore heterogeneity exists between the included studies. Each case in Yu’s paper used a different treatment modality and was performed in different areas of the mouth with no control group. The first 2 cases also had differing adjunctive therapies, including a lateral sinus lift 4 months prior to ridge augmentation, antibiotics, and collagen membranes in addition to amnion chorion. Yu’s report presented low level evidence. |
| Applicability |
In the Gulameabasse review, 11 of the 21 included articles were published in India, therefore some of the results may differ for other populations. This review has very direct clinical applicability for periodontists and oral surgeons since the procedures, techniques, and materials in this article can be used on many different patients in daily practice. Although the first 2 cases in Yu’s report described middle-aged female patients, no patient demographics were discussed for Case 3, therefore direct conclusions regarding study populations could not be made in this report. These studies show that successful clinical outcomes have been achieved in periodontal and oral surgery when using amnion chorion membranes for certain procedures, yet the current literature on this topic is limited and may not apply to all clinical treatments, situations, and patient populations. Amnion chorion membranes used on the palatal donor site as an adjunctive therapy to soft tissue grafting was not directly discussed in these articles. |
| Specialty/Discipline |
(Oral Surgery) (Periodontics) |
| Keywords |
Amnion chorion, autogenous gingival graft, palatal donor site, wound healing
|
| ID# |
3532 |
| Date of submission: |
10/16/2023 |
| E-mail |
yineman@uthscsa.edu |
| Author |
Kylie Yineman, DMD, MPH |
| Co-author(s) |
Jackson Sides, DDS |
| Co-author(s) e-mail |
sides@uthscsa.edu |
| Faculty mentor/Co-author |
Brian Mealey, DDS, MS |
| Faculty mentor/Co-author e-mail |
mealey@uthscsa.edu |
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?) |
post a rationale |
| None available | |
|
Comments and Evidence-Based Updates on the CAT
(FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs) |
post a comment |
| None available | |
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