Using of a Collagen Matrix for Soft Tissue Augmentation in the Frontal Area of the Maxilla
Enhancing the effectiveness of treatment for patients with soft tissue deficiency during dental implant placement in esthetically important areas is a relevant issue in surgical dentistry. To conduct a histomorphometric analysis of soft tissues obtained using a collagen matrix and connective tissue graft. The study included 30 patients who were randomly assigned to two groups. In the first group, a free connective tissue graft from the palate or the tuberosity of the maxilla was used to increase the thickness of soft tissues, while in the second group, a cross-linked collagen matrix was used. Three months after the surgical intervention, a soft tissue biopsy was taken using a mucotome during the placement of gingival formers in the area where tissue thickness had been increased. Results. The biopsy specimens from both groups showed a multi-layered squamous epithelium of relatively large thickness with pronounced acanthosis. The lamina propria of the biopsy specimens, delimited from the epithelium by the basal membrane, was represented by loose connective tissue. The morphometric analysis did not reveal any significant differences between the groups, except for the average value of the number of inflammatory cells in the epithelial layer in the CTG group was equal to 7.1 ± 0.8, while in the CM group – 12.8 ± 1.1 (p = 0.0001), in lamina propria this indicator in the CTG group was equal to 63.8 ± 4.9, and in the CM group – 82.7 ± 9.0 (p = 0.03). The proportion of collagen fibers in the CTG group reached 88.5 = 0.9 %, and in the CM group 82.5 = 1.8 % (0.005). Based on the histomorphometric analysis, it can be concluded that a collagen matrix can be used as a material for increasing the thickness of soft tissues.
Ashurko I.P., Krylova D.A., Shekhter A.B., Davletshin D.N., Tarasenko S.V. 2023. Using of a Collagen Matrix for Soft Tissue Augmentation in the Frontal Area of the Maxilla. Challenges in Modern Medicine. 46 (3): 261–273 (in Russian). DOI: 10.52575/2687-0940-2023-46-3-261-273
While nobody left any comments to this publication.
You can be first.
Ashurko I.P. et al. Otsenka klinicheskoy effektivnosti primeneniya svobodnogo soyedinitel'notkannogo transplantata i kollagenovogo matriksa dlya uvelicheniya tolshchiny myagkikh tkaney v oblasti dental'nykh implantatov [Evaluation of the clinical effectiveness of the use of a free connective tissue graft and a collagen matrix to increase the thickness of soft tissues in the area of dental implants]. Parodontologiya 2022. Vol. 27. No. 2. pp. 117–125. doi.10.33925/1683-3759-2022-27-2-117-125
Tarasenko S.V., Zagorsky S.V. Klinicheskiye rezul'taty sravnitel'nogo analiza sovremennykh metodov konturnoy plastiki desny pri dental'noy implantatsii [Clinical results of comparative analysis of modern methods of contouring of the gum during dental implantation]. Klinicheskaya stomatologiya. 2019. No. 2. pp. 46–49. doi.10.37988/1811-153X_2019_2_46
Angelis P. De et al. 2021. Clinical comparison of a xenogeneic collagen matrix versus subepithelial autogenous connective tissue graft for augmentation of soft tissue around implants // Int. J. Oral. Maxillofac. Surg. Т. 50. № 7. С. 956–963. https://doi.org/10.1016/j.ijom.2020.11.014
Artzi Z. et al. 2022. Histologic composition of marginal mucosal tissue augmented by a resorbable volume-stable collagen matrix in soft tissue thickening procedures in humans: a morphometric observational study // Clin. Oral. Investig. Т. 26. № 1. С. 427–435. https://doi.org/10.1007/s00784-021-04016-1
Ashurko I. et al. 2022a. Connective tissue graft versus xenogeneic collagen matrix for soft tissue augmentation at implant sites: a randomized-controlled clinical trial // Clin. Oral. Investig. Т. 26. № 12. С. 7191–7208. https://doi.org/10.1007/s00784-022-04680-x
Ashurko I.P. et al. 2022b. Comparative histomorphometric analysis of peri-implant soft tissue formed after the augmentation with connective tissue graft and collagen matrix // Rossiiskaya stomatologiya. Т. 15. № 2. С. 22. https://doi.org/10.17116/rosstomat20221502122
Avila-Ortiz G. et al. 2020. The peri-implant phenotype // Journal of Periodontology, 91 (3). С. 283–288.
Baldi N. et al. 2020. Xenogeneic dermal matrix versus autologous connective tissue graft versus no graft at abutment connection for improving aesthetics: 6-month outcomes of a randomised controlled trial // Clinical Trials in Dentistry. Т. 02. № 02. С. 49. https://doi.org/10.36130/CTD.03.2020.05
Caballé-Serrano J. et al. 2020. Tissue Integration and Degradation of a Porous Collagen-Based Scaffold Used for Soft Tissue Augmentation // Materials. Т. 13. № 10. С. 2420. https://doi.org/10.3390/ma13102420
Cairo F. et al. 2019. Surgical procedures for soft tissue augmentation at implant sites. A systematic review and meta-analysis of randomized controlled trials // Clin. Implant. Dent. Relat. Res. С. 1262–1270.
Cosyn J. et al. 2021. A multi-centre randomized controlled trial comparing connective tissue graft with collagen matrix to increase soft tissue thickness at the buccal aspect of single implants: 3-month results // J. Clin. Periodontol. Т. 48. № 12. С. 1502–1515. https://doi.org/10.1111/jcpe.13560
Gargallo-Albiol J. et al. 2019. Efficacy of Xenogeneic Collagen Matrix to Augment Peri-implant Soft Tissue Thickness Compared with Autogenous Connective Tissue Graft: A Systematic Review and Meta-Analysis // Int. J. Oral. Maxillofac. Implants. Т. 34. № 5. С. 1059–1069. https://doi.org/10.11607/jomi.7497
Hélio M. et al. 2019. Peri-implant soft tissue augmentation with palate subepitelial connective tissue graft compared to porcine collagen matrix: A randomized controlled clinical study and histomorphometric analysis // ~ 319 ~ International Journal of Applied Dental Sciences. Т. 5. № 3. С. 319–325.
Lee I. K. et al. 2021. The effect of three surgical therapies to increase keratinized mucosa surrounding dental implants with peri-implantitis: A pilot study // Medicina (Lithuania). Т. 57. № 10. https://doi.org/10.3390/medicina57101093
Lima R. S. R. et al. 2015. Evaluation of the Biological Behavior of Mucograft® in Human Gingival Fibroblasts: An In Vitro Study // Braz. Dent. J. Т. 26. № 6. С. 602–606. https://doi.org/10.1590/0103-6440201300238
Puisys A. et al. 2019. Clinical and Histologic Evaluations of Porcine-Derived Collagen Matrix Membrane Used for Vertical Soft Tissue Augmentation: A Case Series. // Int. J. Periodontics Restorative Dent. С. 341–347.
Rojo E. et al. 2018. Soft tissue volume gain around dental implants using autogenous subepithelial connective tissue grafts harvested from the lateral palate or tuberosity area. A randomized controlled clinical study // J. Clin. Periodontol. Т. 45. № 4. С. 495–503. https://doi.org/10.1111/jcpe.12869
Sanz-Martín I. et al. 2019. Soft tissue augmentation at immediate implants using a novel xenogeneic collagen matrix in conjunction with immediate provisional restorations: A prospective case series // Clin. Implant Dent. Relat. Res. Т. 21. № 1. С. 145–153. https://doi.org/10.1111/cid.12696
Schmitt C.M. et al. 2019. Gingiva thickening with a porcine collagen matrix in a preclinical dog model: Histological outcomes // J. Clin. Periodontol. Т. 46. № 12. С. 1273–1281. https://doi.org/10.1111/jcpe.13196
Song Y.W. et al. 2019. Soft tissue substitutes to increase gingival thickness: Histologic and volumetric analyses in dogs // J. Clin. Periodontol. Т. 46. № 1. С. 96–104. https://doi.org/10.1111/jcpe.13034
Suárez-López Del Amo F. et al. 2019. Comparison of two soft tissue substitutes for the treatment of gingival recession defects: an animal histological study // Journal of Applied Oral Science. Т. 27. https://doi.org/10.1590/1678-7757-2018-0584
Testori T. et al. 2018. Implant placement in the esthetic area: criteria for positioning single and multiple implants // Periodontol 2000. С. 176–196.
Thoma D.S. et al. 2014. Efficacy of soft tissue augmentation around dental implants and in partially edentulous areas: a systematic review // J. Clin. Periodontol. Т. 41. С. S77–S91. https://doi.org/10.1111/jcpe.12220
Thoma D.S. et al. 2016. Randomized controlled clinical study evaluating effec- tiveness and safety of a volume-stable collagen matrix compared to autogenous connective tissue grafts for soft tissue augmentation at implant sites // Journal of Clinical Periodontology, 43 (10). С. 874–885.
Toledano M. et al. 2020a. Differential Biodegradation Kinetics of Collagen Membranes for Bone Regeneration // Polymers (Basel). Т. 12. № 6. С. 1290. https://doi.org/10.3390/polym12061290
Toledano M. et al. 2020b. State of the art on biomaterials for soft tissue augmentation in the oral cavity. Part I: Natural polymers-based biomaterials // Polymers (Basel). Т. 12. № 8. https://doi.org/10.3390/POLYM12081850
Tonetti M.S. et al. 2018. Xenogenic collagen matrix or autologous connective tissue graft as adjunct to coronally advanced flaps for coverage of multiple adjacent gingival recession: Randomized trial assessing non-inferiority in root coverage and superiority in oral health-related // J. Clin. Periodontol. Т. 45. № 1. С. 78–88. https://doi.org/10.1111/jcpe.12834
Zeltner M. et al. 2017. Randomized controlled clinical study comparing a volume-stable collagen matrix to autogenous connective tissue grafts for soft tissue augmentation at implant sites: linear volumetric soft tissue changes up to 3 months // J. Clin. Periodontol. Т. 44. № 4. С. 446–453. https://doi.org/10.1111/jcpe.12697
Zuiderveld E.G. et al. 2018. The influence of different soft-tissue grafting procedures at single implant placement on esthetics: A randomized controlled trial // J. Periodontol. Т. 89. № 8. С. 903–914. https://doi.org/10.1002/JPER.18-0061