A new tunnel technique with acellular dermal matrix for soft tissue preparation prior to symphyseal block graft--a description of technique and case report.

The aim of this report was to describe a newly designed tunnel technique (A New Tunnel Technique) using acellular dermal matrix (ADM) allograft for soft tissue augmentation prior to mono-cortical block graft. Two cases with vertical and horizontal ridge deficiency in the mandibular anterior area were indicated for mono-cortical block grafting before implant placement. Soft tissue evaluation and measurements showed thin tissue covering the defect area composed mainly of nonkeratinized alveolar mucosa measuring 1 to 2 mm in most of the sites. Soft tissue augmentation was done first using a new tunnel technique with ADM allograft. After 2 months of healing, mono-cortical block graft was harvested from the mandibular symphysis area and fixed to the recipient site. Soft tissue measurements were made before soft tissue graft and immediately before block graft. Healing was evaluated at 2, 4, 12, and 24 weeks post-block grafting surgery to evaluate healing. In both cases, there was generalized 1- to 2-mm increase in soft tissue thickness covering the defect areas following allograft. Both cases had healed uneventfully with no soft tissue complications following block grafting procedure to the time of implant placement. The new tunnel technique for soft tissue augmentation using acellular dermal matrix allograft seems to be a valid approach in soft tissue preparation prior to mono-cortical block grafting. Further research is needed to evaluate if this procedure will help to prevent soft tissue complications associated with block grafting.