Clinical trial NCT03454490: Pseudoaneurysm of the Greater Palatine Artery Following Autogenous Connective Tissue Gingival Graft : A Case Series
Official title: Pseudoaneurysm of the Greater Palatine Artery Following Autogenous Connective Tissue Gingival Graft : A Case Series
Study type: OBSERVATIONAL
Overall status: UNKNOWN
Conditions: Pseudoaneurysm
Keywords: Gingival graft
Pseudoaneurysm
Postoperative complication
Gingival recession treatment
Palatine mass
Palatine bleeding
Lead sponsor: Hopital de l'Enfant-Jesus
Sponsor class: OTHER
First posted: 2018-03-06
Enrollment: 10
Sex: ALL
Standard ages: CHILD
ADULT
OLDER_ADULT
Observational model: CASE_ONLY
Time perspective: RETROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Patients having a diagnostic of pseudoaneurysm of the greater palatine artery who had an autogenous connective tissue gingival graft

Brief 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.


Eligibility criteria: 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

Primary outcomes:
measure: Postoperative oral bleeding
timeFrame: One month following autogenous connective tissue gingival graft
Secondary outcomes:
measure: Use of local hemostatic agents
timeFrame: Six months
measure: Secondary effects following angiographic intervention
timeFrame: Six months
measure: Number of followups required
timeFrame: Six months
Other outcomes:
Locations:
Study officials:
affiliation: Hopital de l'Enfant-Jesus, CHU de Quebec, Laval University
name: Melinda Paris, DMD, FRCD
role: STUDY_DIRECTOR
References:
citation: 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.
citation: 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.
citation: 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.
citation: 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.