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

Pseudoaneurysm Clinical Trial

Official title:

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

Clinical Trial Details — Status: Not yet recruiting

Administrative data

• NCT number: NCT03454490
• Other study ID #: Postoperative pseudoaneurysm
• Status: Not yet recruiting
• Phase: N/A
• First received: February 22, 2018
• Last updated: March 2, 2018
• Start date: March 2018
• Est. completion date: July 2018

Study information

• Verified date: March 2018
• Source: Hopital de l'Enfant-Jesus
• Contact: Simon Jean, DMD
• Phone: 1-418-649-0252
• Email: simon.jean.4[@]ulaval.ca
• Is FDA regulated: No
• Study type: Observational

Clinical Trial 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.

Recruitment information / eligibility

• Status: Not yet recruiting
• Enrollment: 10
• Est. completion date: July 2018
• Est. primary completion date: July 2018
• Gender: All
• Age group: N/A and older

Eligibility

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

Related Conditions & MeSH terms

• Aneurysm
• Pseudoaneurysm

Intervention

Procedure:
• Postoperative pseudoaneurysm of the greater palatine artery
Patients had an autogenous connective tissue gingival graft.

Locations

Country	Name	City	State
n/a

Sponsors (1)

Lead Sponsor	Collaborator
Hopital de l'Enfant-Jesus

References & Publications (4)

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. — View 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. — View Citation

Tözüm TF, Keçeli HG, Güncü GN, Hatipoglu H, Sengün D. Treatment of gingival recession: comparison of two techniques of subepithelial connective tissue graft. J Periodontol. 2005 Nov;76(11):1842-8. — View 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 Feb 9. doi: 10.1111/jicd.12325. [Epub ahead of print] Review. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Postoperative oral bleeding	Complication following autogenous connective tissue gingival graft	One month following autogenous connective tissue gingival graft
Secondary	Use of local hemostatic agents	Palliative method before definitive care	Six months
Secondary	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
Secondary	Number of followups required	Secondary effects following angiographic intervention	Six months