Search Results (4)

Background: Tooth loss results in hard- and soft-tissue volume loss over time. We compared the handling of three different soft tissue substitutes (STS) to the subepithelial connective tissue graft (SCTG) for soft tissue volume augmentation in a pig ex vivo model. Methods: Five dentists simultaneously shaped, placed and sutured randomized four graft types in single-tooth soft tissue defects created in pig mandibles. The STS, produced from slightly crosslinked collagen fibres (VCMX), were either 3 mm or 6 mm thick blocks or a newly developed pre-customized saddle-shape. Each graft type was handled 20 times. The time required for shaping, placement, and suturing was recorded. Dentists reported outcomes on the grafts’ handling were evaluated with a visual-analogue-scale (VAS). Statistical analysis included calculating means and medians and testing significance. Results: The mean time of 0.72 min for shaping the pre-customized saddle-shape STS was significantly lower than 1.31 min for SCTG, 1.73 min for 3 mm STS and 2.17 min for 6 mm STS. Placement/suturing time was similar for all grafts. The dentists mainly preferred the saddle-shape STS and the SCTG. Conclusions: The saddle-shape STS required less time for graft-shaping and, therefore, reduced the overall treatment time, suggesting a more efficient and less invasive workflow for soft tissue augmentation. Full article

The mucosa height has always been of interest in modern implant dentistry to obtain biomimetic results. Papilla height, mucosa scalloping, and free mucosal margin level are crucial to achieve “pink aesthetics”. The aim of this study was to investigate the vertical increase in the peri-implant soft tissues with a porcine cross-linked collagen matrix (Geistlich Fibro-Gide^®). Methods: A total of 60 patients were divided into the following three groups: Group 1—patients who received porcine cross-linked collagen matrix for vertical soft tissue augmentation and a cover screw combined with a coronally advanced flap (CAF); Group 2—patients who received the collagen matrix combined with a healing abutment and CAF; Group 3 (control group)—patients who received a traditional surgical approach based on crestal incision and no collagen matrix as well as no CAF. Results: The average horizontal tissue thickness growth after 3 months was more effective for Group 1 (1.35 ± 1.23 mm) compared to Group 2 (0.85 ± 0.67 mm) and the control group (0.20 ± 0.41 mm). The average tissue height growth was 1.05 ± 1.39 mm for Group 1, 0.32 ± 1.28 mm for Group 2, and −0.05 ± 0.39 mm for the control group. Finally, the average increase in the band of keratinized mucosa was 0.60 ± 1.23 mm for Group 1, −0.60 ± 0.94 mm for Group 2, and 0.45 ± 0.60 mm for the control group. Conclusions: The combination of the CAF, porcine cross-linked collagen matrix, and cover screw resulted in better clinical results compared to Group 2 and 3. Full article

Collagen matrices have become a great alternative to the use of connective tissue grafts for soft tissue augmentation procedures. One of the main problems with these matrices is their volume instability and rapid degradation. This study has been designed with the objective of examining the degradation of three matrices over time. For this purpose, pieces of 10 × 10 mm² of Fibro-Gide, Mucograft and Mucoderm were submitted to three different degradation tests—(1) hydrolytic degradation in phosphate buffer solution (PBS); (2) enzyme resistance, using a 0.25% porcine trypsin solution; and (3) bacterial collagenase resistance (Clostridium histolyticum)—over different immersion periods of up to 50 days. Weight measurements were performed with an analytic microbalance. Thickness was measured with a digital caliper. A stereomicroscope was used to obtain the matrices’ images. ANOVA and Student–Newman–Keuls tests were used for mean comparisons (p < 0.05), except when analyzing differences between time-points within the same matrix and solution, where pair-wise comparisons were applied (p < 0.001). Fibro-Gide attained the highest resistance to all degradation challenges. The bacterial collagenase solution was shown to constitute the most aggressive test as all matrices presented 100% degradation before 14 days of storage. Full article

A short inflammatory phase and fast ingrowth of blood vessels and mesenchymal cells are essential for tissue integration of a biomaterial. Macrophages play a key role in this process. We investigated invasion of macrophages, blood vessels, and proliferating cells into a highly porous and volume-stable collagen matrix (VCMX) used for soft tissue augmentation around teeth and dental implants. The biomaterial was implanted in submucosal pouches in the canine maxilla, and the tissue response was analyzed at six different time points. Immunohistochemistry was done for proliferating cells (PCNA), macrophages (MAC387), multinucleated giant cells (CD86), and blood vessels (TGM2). Blood rapidly filled the VCMX pores. During the first week, MAC387+ cells populated the VCMX pores, blood vessels and PCNA+ cells invaded the VCMX, and CD86+ scattered cells were observed. At 15 days, MAC387+ cells were scanty, blood vessels had completely invaded the VCMX, the number of proliferating cells peaked, and fibroblasts appeared. At 30 days, MAC387+ were absent, the numbers of proliferating and CD86+ cells had declined, while blood vessel and fibroblast numbers were high. At 90 days, residual VCMX was well-integrated in soft connective tissue. In conclusion, the VCMX elicited a short inflammatory phase followed by rapid tissue integration. Full article