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

Study Overview
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Brief Summary
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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.

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

Conditions
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Pseudoaneurysm

Intervention / Treatment
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* Procedure: Postoperative pseudoaneurysm of the greater palatine artery


Participation Criteria
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Eligibility Criteria
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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
Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Procedure: Postoperative pseudoaneurysm of the greater palatine artery|Patients had an autogenous connective tissue gingival graft.|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Postoperative oral bleeding | Complication following autogenous connective tissue gingival graft | One month following autogenous connective tissue gingival graft | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Use of local hemostatic agents | Palliative method before definitive care | Six months | 
| Secondary effects following angiographic intervention | Postoperative infection, bone or gum necrosis, extrusion of embolization material, loss of tooth, tooth devitalization following angiographic intervention | Six months | 
| Number of followups required | Secondary effects following angiographic intervention | Six months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Gingival graft, Pseudoaneurysm, Postoperative complication, Gingival recession treatment, Palatine mass, Palatine bleeding