Acellular

This term refers to some form of biological material that is lacking intact cells, not divided into cells or devoid of cells. Consider that an acellular vaccine contains cellular material; however, the cells are not complete. In dentistry, acellular dermis is frequently used to address issues related to gingival tissue. Acellular dermis is biomaterial that is derived from animal or human tissue. This tissue is processed in such a way as to remove cells, while retaining some of the extracellular matrix (ECM). The ECM consists of a collection of extracellular molecules that are secreted by support cells. These cells provide biochemical and structural support to surrounding cells. Although the structure of an extracellular matrix depends on where the tissue originated, all ECMs consist of proteoglycans, collagen fibers and multi adhesive proteins.

Functions of the ECM include:

  • Segregating tissues
  • Controlling the communication that occurs between the cells
  • Forming a support structure for the cells
  • Regulating various cell processes (e.g., migration, growth and differentiation)

Acellular dermal allograft

An allogeneic skin graft is derived from donated human skin. Grafts are used for a variety of soft tissue applications including gingival augmentation, visible root coverage, soft tissue ridge augmentation as well as to address soft tissue augmentation around dental implants. When a gingival graft is necessary, these grafts can be used to eliminate the need for an autograft.

Some acellular dermal allografts are processed using detergent and a sodium chloride solution, which removes the viable dermal cells as well as the epidermis while preserving the skin’s original dermal collagen matrix. By removing the cells, the likelihood of graft rejection or inflammation decreases. The tissue is disinfected with a solution consisting of detergents that have antiseptic and acidic reagents to ensure it passes the sterility standards as set forth by the United States Pharmacopeia Standard 71 (USP <71>). Once it is sterile, the tissue is freeze-dried, then cut to size and packaged using terminally sterilized materials. These acellular dermal allografts are available in a variety of sizes and thicknesses: These pieces of tissue just need to be rehydrated and they are ready to use.

Acellular dermal allograft

An acellular dermal allograft is a soft tissue allograft developed from donated human tissue, which is typically obtained by dental professionals for use in procedures from tissue banks. The native framework of the allograft is maintained, allowing it to be used in a wide variety of applications beyond oral and periodontal surgery, including in cosmetic surgery procedures like lip augmentation and to treat moderate to severe burns. An acellular dermal allograft is extremely safe and effective when building soft tissue, but in rare cases, complications can occur as with any medical procedure. In studies, the only complication recorded was infection, which was treated with antibiotics and did not require graft extrusion. Minimal postoperative pain and swelling was noted, as well as the absence of immunogenicity. Acellular dermal allografts are a viable solution for the treatment of soft tissue deficits and to augment soft tissue where needed for structural or aesthetic purposes.

Acellular dermal matrix graft (ADM)

An acellular dermal matrix graft is similar to the cellular dermal allograft in that they are both derived through the process of removing cells from animal or human tissues while retaining portions of the extracellular matrix (ECM). However, unlike traditional xenografts and allografts, an acellular dermal graft is usually completely devoid of cells. The main components of ADM are elastic fibers and collagen bundles.

There are a variety of acellular dermal graft products available: For example, a regenerative tissue matrix is processed in such a way as to preserve the tissue’s biologic components while maintaining the structure of the dermis itself. Acellular dermal matrix graft products differ in the processing methods used to create them as well as in their size and thickness.

Grafts can be used for numerous soft tissue applications, including:

  • Soft tissue ridge augmentation
  • Gingival augmentation
  • Soft tissue augmentation around implants
  • Exposed root coverage

If a gingival graft is required, an acellular dermal graft can be used as an alternative to an autograft.

Acetaminophen

Acetaminophen reduces inflammation, which makes it ideal for dental implant care. This medication is an antipyretic and nonopioid analgesic that consists of p-aminophenol and acetic acid. While the actual mechanism responsible for providing the pain relieving and fever reducing benefits of acetaminophen is unknown, it is believed that this medication reduces the amount of prostaglandins the body produces: Prostaglandins are the chemicals produced in the brain that cause inflammation. Many patients choose to use acetaminophen for dental implant care following their procedure; however, unless directed by a physician, this medication should not be taken for a period longer than 10 days. Acetaminophen can be administered orally or rectally.

Adult dosage of acetaminophen for dental pain depends on the formula being used:

  • Immediate release formulations of acetaminophen – 325 mg to 650 mg every 4 hours
  • Extended release caplets – 1300 mg every 8 hours
  • Maximum adult daily dosage of acetaminophen is 4 grams