Choice of Acellular dermis (ADM) vs Autogenous Tissue?

@drdangober What criteria do you use to determine if you should use Acellular dermis (ADM) vs autogenous tissue for a connective tissue graft or FGG?

This is an interesting question that I think will depend on who you ask. I have success with ADM when it comes to root coverage in the presence of a nice band of keratinized tissue. Personally, I do not use it as a substitute for Free Gingival Grafts because it does not have the genotype that will induce keratinization. It can be used, however, for simple vestibular extension. BUT I must admit that I have seen people use ADM successfully for root coverage even in challenging cases with limited KT via a tunnelling technique- I just haven’t been able to translate that into my own experience at this point. Also, I really like using ADM for soft tissue ridge augmentation around implants- I have seen really nice results with that.