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Marques D, Teixeira LN, Elias CN, Lemos AB, Martinez EF. Surface topography of resorbable porcine collagen membranes, and their effect on early osteogenesis: An in vitro study. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101607. [PMID: 37582461 DOI: 10.1016/j.jormas.2023.101607] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/08/2023] [Accepted: 08/12/2023] [Indexed: 08/17/2023]
Abstract
OBJECTIVE Guided tissue regeneration (GTR) is based on the use of different membranes that function as sealants and barriers in specific clinical situations. Among the several tissue production methods and origins, resorbable porcine-derived membranes are the most commonly used. Because these membranes are so diverse, and have several different clinical applications, doubts linger as to their effect in stimulating osteogenesis. The objective of this study was to make an in vitro evaluation of the viability and differentiation of osteoblastic cells cultured on the surface of the following collagen membranes: Jason® (Botiss Biomaterials), Collprotect® (Botiss Biomaterials), and Bio-Gide® (Geistlich). MATERIAL AND METHODS Fragments of the 3 resorbable collagen membranes (5 × 5 mm) were used, and pre-osteoblastic SAOS-2 cells (ATCC, USA) were plated on their porous surfaces. Evaluation of the membranes was performed at 3, 5 and 7 days, considering the following parameters: (1) topographic analysis of the different surfaces by scanning electron microscope; (2) cellular viability by MTT, (3) quantification of type I collagen and osteopontin by Elisa. The quantitative analyses were carried out using a significance level of 5%. RESULTS Collprotect® and Jason® membranes presented a rough surface with an irregular aspect on both sides, while double-layered Bio-Gide® had one layer with a smooth surface and the other with a rough surface along each respective length. The viability assays revealed that the cells cultured the cells grown on Collprotect® showed higher viability than those grown in Bio-Gide® or Jason®, especially after 5 and 7 days. After 3 and 5 days, evaluation of type I collagen showed that the cells plated on the Jason® and Collprotect® surfaces had greater collagen secretion than those plated on BioGide®. After 7 days, an increase in osteopontin levels was observed when the cells were plated on all the experimental membranes, compared with the control group. CONCLUSION All the tested membranes were suitable for use in GTR clinical procedures. Their indication in specific regenerative cases depends on the mechanical and biological properties of their originating tissues, thus enabling better results and assertive choices by dental professionals.
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Affiliation(s)
- Dalton Marques
- Division of Oral Implantology, Faculdade São Leopoldo Mandic, Campinas, SP, Brazil
| | | | - Carlos Nelson Elias
- Instituto Militar de Engenharia, Departamento de Ciência dos Materiais, Rio de Janeiro, RJ, Brasil
| | - Alexandre Barboza Lemos
- Division of Oral Implantology, Faculdade São Leopoldo Mandic, Campinas, SP, Brazil; Instituto Militar de Engenharia, Departamento de Ciência dos Materiais, Rio de Janeiro, RJ, Brasil
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Michels R, Magrin GL, Cruz ACC, Magini RS, Benfatti CAM. Functionalization of a Volume-Stable Collagen Matrix Using Liquid Platelet-Rich Fibrin: A Case Report Presenting a New Approach for Root Coverage. Case Rep Dent 2023; 2023:3929269. [PMID: 37006702 PMCID: PMC10060066 DOI: 10.1155/2023/3929269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 01/29/2023] [Accepted: 02/04/2023] [Indexed: 04/04/2023] Open
Abstract
This case report presents a novel approach for root coverage of multiple gingival recessions with a volume-stable collagen matrix functionalized with injectable platelet-rich fibrin (i-PRF). A patient with multiple gingival recessions in the anterior maxilla was submitted to root coverage by coronally advanced flap with split-full-split incisions. Blood collection was performed before surgery and i-PRF was obtained after centrifugation (relative centrifugal force (RCF) 400 g, 2700 rpm, 3 minutes). A volume-stable collagen matrix was soaked with i-PRF and applied as a substitute for autogenous connective tissue graft. A mean root coverage of 83% was observed after a 12-month follow-up period, and only slight modifications were detected in a 30-month follow-up consultation. The association of a volume-stable collagen matrix with i-PRF successfully treated multiple gingival recessions with reduced morbidity since a connective tissue collection was avoided.
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Affiliation(s)
- Roberta Michels
- Center for Education and Research on Dental Implants (CEPID), Post-Graduate Program in Dentistry (PPGO), Federal University of Santa Catarina (UFSC), Florianópolis, Brazil
| | - Gabriel Leonardo Magrin
- Center for Education and Research on Dental Implants (CEPID), Post-Graduate Program in Dentistry (PPGO), Federal University of Santa Catarina (UFSC), Florianópolis, Brazil
| | - ACC Cruz
- Center for Education and Research on Dental Implants (CEPID), Post-Graduate Program in Dentistry (PPGO), Federal University of Santa Catarina (UFSC), Florianópolis, Brazil
| | - RS Magini
- Center for Education and Research on Dental Implants (CEPID), Post-Graduate Program in Dentistry (PPGO), Federal University of Santa Catarina (UFSC), Florianópolis, Brazil
| | - Cesar Augusto Magalhães Benfatti
- Center for Education and Research on Dental Implants (CEPID), Post-Graduate Program in Dentistry (PPGO), Federal University of Santa Catarina (UFSC), Florianópolis, Brazil
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3
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Ashurko I, Tarasenko S, Esayan A, Kurkov A, Mikaelyan K, Balyasin M, Galyas A, Kustova J, Taschieri S, Corbella S. Connective tissue graft versus xenogeneic collagen matrix for soft tissue augmentation at implant sites: a randomized-controlled clinical trial. Clin Oral Investig 2022; 26:7191-7208. [PMID: 36029335 DOI: 10.1007/s00784-022-04680-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 08/10/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The purpose of this randomized clinical trial (RCT) is to compare xenogeneic collagen matrix (XCM) versus subepithelial connective tissue graft (SCTG) to increase soft tissue thickness at implant site. MATERIALS AND METHODS The study was a randomized, parallel-group controlled investigation. Thirty patients underwent buccal soft tissue thickness augmentation at the stage of implant placement by two different methods: SCTG (control group) and XCM (test group). Primary outcome was the amount of buccal soft tissue thickness gain, 3 months after the intervention. Secondary outcomes were the operation time, the amount of keratinized mucosa (KM), pain syndrome (PS), and patients' quality of life (QL). Histologic evaluation was also performed. RESULTS The amount of soft tissue thickness gain was 1.55±0.11 mm in SCTG group, and 1.18±0.11mm in XCM group. The difference between the SCTG and XCM was -0.366 (-0.66 to -0.07; p=0.016). Operation time with XCM was 8.4 (3.737 to 13.06) min shorter than that with the SCTG (p=0.001). KT, PS, and QL for both groups were not statistically significantly different at any time point (p>0.05). At histological examination, the general picture in both groups was similar. No significant differences between the studied groups in most indices, except for the average and maximum formation thickness, cellularity of the basal, mitotic activity and also maximum length of rete ridges. CONCLUSION Within limitations, this study demonstrates that the use of SCTG provides a statistically significant superior soft tissue thickness gain than XCM for soft tissue augmentation procedures around implants. CLINICAL RELEVANCE XCM can be used as the method of choice for increasing the thickness of soft tissues.
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Affiliation(s)
- Igor Ashurko
- Department of Oral Surgery of the Institute of Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 11 Mozhaisky Val Street, Moscow, 119048, Russian Federation.
| | - Svetlana Tarasenko
- Department of Oral Surgery of the Institute of Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 11 Mozhaisky Val Street, Moscow, 119048, Russian Federation
| | - Aleksandr Esayan
- Department of Oral Surgery of the Institute of Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 11 Mozhaisky Val Street, Moscow, 119048, Russian Federation
| | - Alexandr Kurkov
- Department of Oral Surgery of the Institute of Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 11 Mozhaisky Val Street, Moscow, 119048, Russian Federation
| | - Karen Mikaelyan
- Department of Oral Surgery of the Institute of Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 11 Mozhaisky Val Street, Moscow, 119048, Russian Federation
| | - Maxim Balyasin
- Peoples Friendship University of Russia, Moscow, Russian Federation
| | - Anna Galyas
- Department of Oral Surgery of the Institute of Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 11 Mozhaisky Val Street, Moscow, 119048, Russian Federation
| | - Julia Kustova
- Department of Oral Surgery of the Institute of Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 11 Mozhaisky Val Street, Moscow, 119048, Russian Federation
| | - Silvio Taschieri
- Department of Oral Surgery of the Institute of Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 11 Mozhaisky Val Street, Moscow, 119048, Russian Federation
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
- Department of Biomedica, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
| | - Stefano Corbella
- Department of Oral Surgery of the Institute of Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 11 Mozhaisky Val Street, Moscow, 119048, Russian Federation
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
- Department of Biomedica, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
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Wu Y, Chen S, Luo P, Deng S, Shan Z, Fang J, Liu X, Xie J, Liu R, Wu S, Wu X, Chen Z, Yeung KWK, Liu Q, Chen Z. Optimizing the bio-degradability and biocompatibility of a biogenic collagen membrane through cross-linking and zinc-doped hydroxyapatite. Acta Biomater 2022; 143:159-172. [PMID: 35149241 DOI: 10.1016/j.actbio.2022.02.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 02/03/2022] [Accepted: 02/03/2022] [Indexed: 01/07/2023]
Abstract
Biogenic collagen membranes have been widely used as soft tissue barriers in guided bone regeneration (GBR) and guided tissue regeneration (GTR). Nevertheless, their clinical performance remains unsatisfactory because of their low mechanical strength and fast degradation rate in vivo. Although cross-linking with chemical agents is effective and reliable for prolonging the degradation time of collagen membranes, some adverse effects including potential cytotoxicity and undesirable tissue integration have been observed during this process. As a fundamental nutritional trace element, zinc plays an active role in promoting the growth of cells and regulating the degradation of the collagen matrix. Herein, a biogenic collagen membrane was cross-linked with glutaraldehyde-alendronate to prolong its degradation time. The physiochemical and biological properties were enhanced by the incorporation of zinc-doped nanohydroxyapatite (nZnHA), with the native structure of collagen preserved. Specifically, the cross-linking combined with the incorporation of 1% and 2% nZnHA seemed to endow the membrane with the most appropriate biocompatibility and tissue integration capability among the cross-linked membranes, as well as offering a degradation period of six weeks in a rat subcutaneous model. Thus, improving the clinical performance of biogenic collagen membranes by cross-linking together with the incorporation of nZnHA is a promising strategy for the improvement of biogenic collagen membranes. STATEMENT OF SIGNIFICANCE: The significance of this research includes.
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Affiliation(s)
- You Wu
- Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, China
| | - Shoucheng Chen
- Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, China
| | - Pu Luo
- Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, China
| | - Shudan Deng
- Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, China
| | - Zhengjie Shan
- Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, China
| | - Jinghan Fang
- Department of Orthopaedics and Traumatology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China; Shenzhen Key Laboratory for Innovative Technology in Orthopaedic Trauma, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Xingchen Liu
- Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, China
| | - Jiaxin Xie
- Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, China
| | - Runheng Liu
- Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, China
| | - Shiyu Wu
- Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, China
| | - Xiayi Wu
- Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, China
| | - Zetao Chen
- Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, China
| | - Kelvin W K Yeung
- Department of Orthopaedics and Traumatology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China; Shenzhen Key Laboratory for Innovative Technology in Orthopaedic Trauma, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Quan Liu
- Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, China.
| | - Zhuofan Chen
- Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, China.
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Pabst A, Sagheb K, Blatt S, Sagheb K, Schröger S, Wentaschek S, Schumann S. Biomechanical Characterization of a New Acellular Dermal Matrix for Oral Soft Tissue Regeneration. J INVEST SURG 2022; 35:1296-1303. [DOI: 10.1080/08941939.2022.2047245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Andreas Pabst
- Department of Oral and Maxillofacial Surgery, Federal Armed Forces Hospital, Koblenz, Germany
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Mainz, Germany
| | - Keyvan Sagheb
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Mainz, Germany
| | - Sebastian Blatt
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Mainz, Germany
| | - Kawe Sagheb
- Department of Prosthodontics, University Medical Center Mainz, Mainz, Germany
| | - Saskia Schröger
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Mainz, Germany
| | - Stefan Wentaschek
- Department of Prosthodontics, University Medical Center Mainz, Mainz, Germany
| | - Sven Schumann
- Institute for Microscopic Anatomy and Neurobiology, University Medical Center Mainz, Mainz, Germany
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Friedmann A, Fickl S, Fischer KR, Dalloul M, Goetz W, Kauffmann F. Horizontal Augmentation of Chronic Mandibular Defects by the Guided Bone Regeneration Approach: A Randomized Study in Dogs. MATERIALS (BASEL, SWITZERLAND) 2021; 15:238. [PMID: 35009383 PMCID: PMC8746186 DOI: 10.3390/ma15010238] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 12/07/2021] [Accepted: 12/20/2021] [Indexed: 06/14/2023]
Abstract
Various biomaterial combinations have been studied focusing on their ability to stabilize blood clots and maintain space under soft tissue to support new bone formation. A popular combination is Deproteinized Bovine Bone Mineral (DBBM) placed with a native collagen membrane (NCM) tacked to native bone. In this study, we compared the outcome of this treatment option to those achieved with three different graft/membrane combinations with respect to total newly occupied area and the mineralized compound inside. After bi-lateral extraction of two mandibular premolars in five adult beagles L-shaped alveolar defects were created. A total of 20 defects healed for 6 weeks resulting in chronic type bone defects. At baseline, four options were randomly allocated to five defects each: a. DBBM + NCM with a four-pin fixation across the ridge; b. DBBM + RCLC (ribose cross-linked collagen membrane); c. DBBM + NPPM (native porcine pericardium membrane); and d. Ca-sulfate (CS) + RCLC membrane. Membranes in b/c/d were not fixed; complete tensionless wound closure was achieved by CAF. Termination after 3 months and sampling followed, and non-decalcified processing and toluidine blue staining were applied. Microscopic images obtained at standardized magnification were histomorphometrically assessed by ImageJ software (NIH). An ANOVA post hoc test was applied; histomorphometric data are presented in this paper as medians and interquartile ranges (IRs). All sites healed uneventfully, all sites were sampled and block separation followed before Technovit embedding. Two central sections per block for each group were included. Two of five specimen were lost due to processing error and were excluded from group b. New bone area was significantly greater for option b. compared to a. (p = 0.001), c. (p = 0.002), and d. (p = 0.046). Residual non-bone graft area was significantly less for option d. compared to a. (p = 0.026) or c. (p = 0.021). We conclude that collagen membranes with a prolonged resorption/barrier profile combined with bone substitutes featuring different degradation profiles sufficiently support new bone formation. Tacking strategy/membrane fixation appears redundant when using these biomaterials.
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Affiliation(s)
- Anton Friedmann
- Department of Periodontology, Faculty of Health, School of Dentistry, Witten/Herdecke University, 58455 Witten, Germany;
| | - Stefan Fickl
- Department of Periodontology, University of Würzburg, 97070 Würzburg, Germany;
- Private Office, 90762 Fürth, Germany
| | - Kai R. Fischer
- Center of Dental Medicine, Clinic for Conservative Preventive Dentistry, Division for Periodontology & Peri-Implant Diseases, University of Zurich, 8032 Zurich, Switzerland;
| | - Milad Dalloul
- Department of Periodontology, Faculty of Health, School of Dentistry, Witten/Herdecke University, 58455 Witten, Germany;
- Private Office, 56727 Koblenz, Germany
| | - Werner Goetz
- Department for Orthodontics, Friedrich-Wilhelm-University Bonn, 53111 Bonn, Germany;
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Han CY, Wang DZ, Bai JF, Zhao LL, Song WZ. Peri-implant keratinized gingiva augmentation using xenogeneic collagen matrix and platelet-rich fibrin: A case report. World J Clin Cases 2021; 9:10738-10745. [PMID: 35005010 PMCID: PMC8686158 DOI: 10.12998/wjcc.v9.i34.10738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 09/14/2021] [Accepted: 10/11/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Keratinized gingival insufficiency is a disease attributed to long-term tooth loss, can severely jeopardizes the long-term health of implants. A simple and effective augmentation surgery method should be urgently developed.
CASE SUMMARY A healthy female patient, 45-year-old, requested implant restoration of the her left mandibular first molar and second molar. Before considering a stage II, as suggested from the probing depth measurements, the widths of the mesial, medial, and distal buccal keratinized gingiva of second molar (tooth #37) were measured and found to be 0.5 mm, 0.5 mm, and 0 mm, respectively. This suggested that the gingiva was insufficient to resist damage from bacterial and mechanical stimulation. Accordingly, modified apically repositioned flap (ARF) surgery combined with xenogeneic collagen matrix (XCM) and platelet-rich fibrin (PRF) was employed to increase the width of gingival tissue. After 1 mo of healing, the widths of mesial, medial, and distal buccal keratinized gingiva reached 4 mm, 4 mm, and 3 mm, respectively, and the thickness of the augmented mucosa was 4.5 mm. Subsequently, through the second-stage operation, the patient obtained an ideal soft tissue shape around the implant.
CONCLUSION For cases with keratinized gingiva widths around implants less than 2mm,the soft tissue width and thickness could be increased by modified ARF surgery combined with XCM and PRF. Moreover, this surgery significantly alleviated patients’ pain and ameliorated oral functional comfort.
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Affiliation(s)
- Chun-Yu Han
- Department of Stomatology, China-Japan Union Hospital, Jilin University, Changchun 130031, Jilin Province, China
| | - De-Zhou Wang
- Department of Stomatology, China-Japan Union Hospital, Jilin University, Changchun 130031, Jilin Province, China
| | - Jian-Fei Bai
- Department of Stomatology, China-Japan Union Hospital, Jilin University, Changchun 130031, Jilin Province, China
| | - Lan-Lan Zhao
- Department of Stomatology, China-Japan Union Hospital, Jilin University, Changchun 130031, Jilin Province, China
| | - Wen-Zhi Song
- Department of Stomatology, China-Japan Union Hospital, Jilin University, Changchun 130031, Jilin Province, China
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Raghoebar GM, Korfage A, Meijer HJA, Gareb B, Vissink A, Delli K. Linear and profilometric changes of the mucosa following soft tissue augmentation in the zone of aesthetic priority: A systematic review and meta-analysis. Clin Oral Implants Res 2021; 32 Suppl 21:138-156. [PMID: 34642988 DOI: 10.1111/clr.13759] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 04/02/2021] [Accepted: 04/22/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVES To assess the outcomes of soft tissue augmentation, in terms of change in level and thickness of mid-buccal mucosa, at implants sites in the zone of the aesthetic priority. MATERIAL AND METHODS MEDLINE, EMBASE and Cochrane Central Register of Controlled Trials databases were searched (last search on 1 June 2020). Inclusion criteria were studies reporting outcomes of different materials and timing of grafting in patients undergoing soft tissue augmentation at implant sites in the aesthetic zone with a follow-up of ≥1 year after implant placement. Outcome measures assessed included changes in level and thickness of mid-buccal mucosa, implant survival, peri-implant health and patients' satisfaction. RESULTS Eighteen out of 2,185 articles fulfilled the inclusion criteria. Meta-analysis revealed a significant difference in vertical mid-buccal soft tissue change (0.34 mm, 95% CI: 0.13-0.56, p = .002) and mid-buccal mucosa thickness (0.66 mm, 95% CI: 0.35-0.97, p < .001) following immediate implant placement in favour of the use of a graft versus no graft. Mean difference in mid-buccal mucosa level following delayed implant placement (0.17 mm, 95% CI: 0.01-0.34, p = .042) was also in favour of the use of a graft versus no graft. With regard to mucosa thickness, the use of a graft was not in favour compared with no graft following delayed implant placement (0.22 mm, 95% CI: -0.04-0.47, p = .095). Observed changes remained stable in the medium term. CONCLUSION Soft tissue augmentation in the zone of the aesthetic priority results in less recession and a thicker mid-buccal mucosa following immediate implant placement and less recession in mid-buccal mucosa following delayed implant placement compared with no graft.
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Affiliation(s)
- Gerry M Raghoebar
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Anke Korfage
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Henny J A Meijer
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Department of Implant Dentistry, University of Groningen, University Medical Center Groningen, Centre for Dentistry and Oral Hygiene, Groningen, The Netherlands
| | - Barzi Gareb
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Arjan Vissink
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Konstantina Delli
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Alccayhuaman KAA, Tangl S, Blouin S, Hartmann MA, Heimel P, Kuchler U, Lee JS, Gruber R. Osteoconductive Properties of a Volume-Stable Collagen Matrix in Rat Calvaria Defects: A Pilot Study. Biomedicines 2021; 9:biomedicines9070732. [PMID: 34202317 PMCID: PMC8301482 DOI: 10.3390/biomedicines9070732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 06/16/2021] [Accepted: 06/16/2021] [Indexed: 11/17/2022] Open
Abstract
Volume-stable collagen matrices (VSCM) are conductive for the connective tissue upon soft tissue augmentation. Considering that collagen has osteoconductive properties, we have investigated the possibility that the VSCM also consolidates with the newly formed bone. To this end, we covered nine rat calvaria circular defects with a VSCM. After four weeks, histology, histomorphometry, quantitative backscattered electron imaging, and microcomputed tomography were performed. We report that the overall pattern of mineralization inside the VSCM was heterogeneous. Histology revealed, apart from the characteristic woven bone formation, areas of round-shaped hypertrophic chondrocyte-like cells surrounded by a mineralized extracellular matrix. Quantitative backscattered electron imaging confirmed the heterogenous mineralization occurring within the VSCM. Histomorphometry found new bone to be 0.7 mm2 (0.01 min; 2.4 max), similar to the chondrogenic mineralized extracellular matrix with 0.7 mm2 (0.0 min; 4.2 max). Microcomputed tomography showed the overall mineralized tissue in the defect to be 1.6 mm3 (min 0.0; max 13.3). These findings suggest that in a rat cranial defect, VSCM has a limited and heterogeneous capacity to support intramembranous bone formation but may allow the formation of bone via the endochondral route.
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Affiliation(s)
- Karol Alí Apaza Alccayhuaman
- Department of Oral Biology, Dental School, Medical University of Vienna, Sensengasse 2a, 1090 Vienna, Austria; (K.A.A.A.); (J.-S.L.)
- Karl Donath Laboratory for Hard Tissue and Biomaterial Research, Division of Oral Surgery, School of Dentistry, Medical University of Vienna, 1090 Vienna, Austria; (S.T.); (P.H.)
| | - Stefan Tangl
- Karl Donath Laboratory for Hard Tissue and Biomaterial Research, Division of Oral Surgery, School of Dentistry, Medical University of Vienna, 1090 Vienna, Austria; (S.T.); (P.H.)
- Austrian Cluster for Tissue Regeneration, Medical University of Vienna, 1200 Vienna, Austria
| | - Stéphane Blouin
- 1st Medical Department, Ludwig Boltzmann Institute of Osteology at the Hanusch Hospital of OEGK and AUVA Trauma Centre Meidling, Hanusch Hospital, 1140 Vienna, Austria; (S.B.); (M.A.H.)
| | - Markus A. Hartmann
- 1st Medical Department, Ludwig Boltzmann Institute of Osteology at the Hanusch Hospital of OEGK and AUVA Trauma Centre Meidling, Hanusch Hospital, 1140 Vienna, Austria; (S.B.); (M.A.H.)
| | - Patrick Heimel
- Karl Donath Laboratory for Hard Tissue and Biomaterial Research, Division of Oral Surgery, School of Dentistry, Medical University of Vienna, 1090 Vienna, Austria; (S.T.); (P.H.)
- Austrian Cluster for Tissue Regeneration, Medical University of Vienna, 1200 Vienna, Austria
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, 1200 Vienna, Austria
| | - Ulrike Kuchler
- Department of Oral Surgery, Medical University of Vienna, 1090 Vienna, Austria;
| | - Jung-Seok Lee
- Department of Oral Biology, Dental School, Medical University of Vienna, Sensengasse 2a, 1090 Vienna, Austria; (K.A.A.A.); (J.-S.L.)
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul 03722, Korea
| | - Reinhard Gruber
- Department of Oral Biology, Dental School, Medical University of Vienna, Sensengasse 2a, 1090 Vienna, Austria; (K.A.A.A.); (J.-S.L.)
- Austrian Cluster for Tissue Regeneration, Medical University of Vienna, 1200 Vienna, Austria
- Department of Periodontology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland
- Correspondence: ; Tel.: +43-1-40070-2660
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