title: Adverse effects associated with a bioabsorbable guided tissue regeneration device in the treatment of human gingival recession defects. A clinicopathologic case report.
abstract: This clinicopathologic case report documents an adverse effect associated with the use of a polylactic acid-based barrier in the treatment of human gingival recession defects. A total of 27 consecutively treated patients, in whom guided tissue regeneration with a polylactic acid barrier was used to correct gingival recession defects, were evaluated. This adverse effect consisted of a midradicular-apical swelling, generally asymptomatic, with no apparent predilection for gender, age, tooth type or location (maxilla/mandible), or surgical procedure. It was observed in 14 of 27 (52%) patients and 22 of 41 (54%) defects. The swelling decreased in size over time and in most cases, it completely resolved within 12 months postsurgery. Histopathologic evaluation of a 14-week specimen indicated characteristics (multinucleated giant cells, foamy macrophages) consistent with a foreign body reaction. These findings suggest that patients undergoing GTR procedures with synthetic absorbable devices for the treatment of gingival recession defects should be advised of the possible occurrence of such an adverse effect.
authors.affiliation: Advanced Education Program in Periodontics and Implant Surgery, School of Dentistry, Loma Linda University, CA 92354, USA. dtatakis@sd.llu.edu
authors.forename: D N
authors.initials: DN
authors.lastname: Tatakis
authors.forename: L
authors.initials: L
authors.lastname: Trombelli
mesh_terms: D020341:Absorbable Implants / Q000009:adverse effects*; D000328:Adult; D001672:Biocompatible Materials / Q000009:adverse effects*; D004487:Edema / Q000209:etiology / Q000473:pathology; D005260:Female; D005487:Foam Cells / Q000473:pathology; D005500:Follow-Up Studies; D005549:Foreign-Body Reaction / Q000209:etiology / Q000473:pathology; D015726:Giant Cells / Q000473:pathology; D005889:Gingival Recession / Q000601:surgery*; D005891:Gingivitis / Q000209:etiology / Q000473:pathology; D016557:Guided Tissue Regeneration, Periodontal / Q000009:adverse effects / Q000295:instrumentation*; D006801:Humans; D019344:Lactic Acid / Q000009:adverse effects*; D008297:Male; D008567:Membranes, Artificial; D008875:Middle Aged; D011091:Polyesters; D011108:Polymers / Q000009:adverse effects*; D012075:Remission, Spontaneous
chemical_list: D001672:Biocompatible Materials; D008567:Membranes, Artificial; D011091:Polyesters; D011108:Polymers; D019344:Lactic Acid; C033616:poly(lactide)