Dimensional changes of peri-implant tissues with connective tissue grafts vs. with xenogenic matrices
Keywords:
dental implants, alveolar ridge augmentation, autologous transplant, heterologous transplant.Abstract
Objective: Compare the dimensional changes of peri-implant tissues from the esthetic zone after the second surgical stage of autogenous connective tissue grafting vs. a xenogenic collagen matrix after three months' healing.
Methods: A case-series of six patients with alveolar ridge defects underwent a soft tissue volume augmentation procedure, randomly assigning two treatment modes: subepithelial connective tissue graft and acellular dermal collagen matrix. Impressions were taken before augmentation and at 90 days to evaluate the dimensional changes. These were then emptied to obtain plaster models which were then digitalized. The two images were superimposed, and upon definition of three points of interest, the dimensional changes were estimated in millimeters with the software D500 3D dental scanner (3Shape, Copenhagen, Denmark). Inquiries were made about the pain experienced by patients using a visual analogue scale.
Results: Ninety days after surgery, increase in thickness of peri-implant soft tissues was 0.77 mm (range 0.0-1.3) for the connective tissue graft and 0.89 mm (range 0.3-1.5) for the acellular dermal matrix. No statistically significant differences were found between the two treatment modes at any of the three points evaluated per patient (p= 0.83, p= 0.83, p= 0.51). With respect to the pain experienced between the first and the seventh days, no statistically significant differences were found in the recipient zone intergroup (p= 0.07, p= 0.12), the graft intragroup (p= 0.11) and the matrix (p= 0.32), or in the donor zone of the graft group (p= 0.11).
Conclusions: Increase in the thickness of peri-implant tissues after 90 days was similar in the two study groups.Downloads
References
Nauta A, Gurtner GC, Longaker MT. Wound healing and regenerative strategies. Oral Dis. 2011;17(6):541-9.
Zuhr O, Baumer D, Hürzeler M. The addition of soft tissue replacement grafts in plastic periodontal and implant surgery: critical elements in design and execution. J Clin Periodontol. 2014;41(15):123-42.
Levine RA, Huynh-Ba G, Cochran DL. Soft tissue augmentation procedures for mucogingival defects in esthetic sites. Int J Oral Maxillofac Implants. 2014;29(2):155-85.
Pini-Prato GP, Cairo F, Tinti C, Cortellini P, Muzzi L, Mancini EA. Prevention of alveolar ridge deformities and reconstruction of lost anatomy: a review of surgical approaches. Int J Periodontics Restorative Dent. 2004;24(5):434-45.
Linkevicius T, Puisys A, Steigmann M, Vindasiute E, Linkeviciene L. Influence of vertical soft thickness on crestal bone changes around implants with platform switching: a comparative clinical study. Clin Implant Dent Relat Res. 2015;17(6):1228-36.
Thoma DS, Buranawat B, Hammerle CH, Held U, Jung RE. Efficacy of soft tissue augmentation around dental implants and in partially edentulous areas: a systematic review. J Clin Periodontol. 2017;41(15):77-91.
Benninger B, Andrews K, Carter W. Clinical measurements of hard palate and implications for subepithelial connective tissue grafts with suggestions for palatal nomenclature. J Oral Maxillofac Surg. 2012;70(1):149-53.
Yu SK, Lee MH, Kim CS, Kim DK, Kim HJ. Thickness of the palatal masticatory mucosa with reference to autogenous grafting: a cadaveric and histologic study. Int J Periodontics Restorative Dent. 2014;34(1):115-21.
Burkhardt R, Hämmerle CH, Lang NP. Self-reported pain perception of patients after mucosal graft harvesting in the palatal area. J Clin Periodontol. 2015;42(3):281-7.
Batista EL Jr, Batista FC, Novaes AB Jr. Management of soft tissue ridge deformities with acellular dermal matrix. Clinical approach and outcome after 6 months of treatment. J Periodontol 2001;72(2):265-73.
Schneider D, Grunder U, Ender A, Hämmerle CH, Jung RE. Volume gain and stability of peri-implant tissue following bone and soft tissue augmentation: 1-year results from a prospective cohort study. Clin Oral Implants Res. 2011;22(1):28-37.
Thoma DS, Jung RE, Schneider D, Cochran DL, Ender A, Jones AA, et al. Soft tissue volume augmentation by the use of collagen-based matrices: a volumetric analysis. J Clin Periodontol. 2010;37(7):659-66.
Thoma DS, Zeltner M, Hilbe M, Hämmerle CHF, Hüsler J, Jung RE. Randomized controlled clinical study evaluating effectiveness and safety of a volume-stable collagen matrix compared to autogenous connective tissue grafts for soft tissue augmentation at implant sites. J Clin Periodontol. 2016;43(10):874-85.
Wiesner G, Esposito M, Worthington H, Schlee M. Connective tissue grafts for thickening peri-implant tissues at implant placement. One-year results from an explanatory split-mouth randomised controlled clinical trial. Eur J Oral Implantol. 2010;3(1):27-35.
Zuiderveld EG, Meijer HJA, den Hartog L, Vissink A, Raghoebar GM. Effect of connective tissue grafting on peri-implant tissue in single immediate implant sites: A RCT. J Clin Periodontol. 2018;45(9):253-64.
De Bruyckere T, Eghbali A, Younes F, De Bruyn H, Cosyn J. Horizontal stability of connective tissue grafts at the buccal aspect of single implants: a 1-year prospective case series. J Clin Periodontol. 2015;42(9):876-82.
Zeltner M, Jung RE, Hämmerle CHF, Hüsler J, Thoma DS. 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. 2017;44(4):446-53.
Schmitt CM, Matta RE, Moest T, Humann J, Gammel L, Neukam FW, et al. Soft tissue volume alterations after connective tissue grafting at teeth: the subepithelial autologous connective tissue graft versus a porcine collagen matrix – a pre-clinical volumetric analysis. J Clin Periodontol. 2016;43(7):609-17.
Díaz-Romeral P, López E, Veny T, Orejas J. Materiales y técnicas de impresión en prótesis fija dentosoportada. Cient Dent. 2007;4(1):71-82.
Antunes C, Sanches T, Piola FA, Yoshio A, Antunes M. Linear setting expansion of different gypsum products. RSBO. 2015;12(1):61-7.
Rhee YK, Huh YH, Cho LR, Park CJ. Comparison of intraoral scanning and conventional impression techniques using 3-dimensional superimposition. J Adv Prosthodont. 2015;7(6):460-7.
Downloads
Published
How to Cite
Issue
Section
License
Authors retain all rights to their works, which they can reproduce and distribute as long as they cite the primary source of publication.
The Rev Cubana Estomatol is subject to the Creative Commons Attribution-Non-Commercial 4.0 International License (CC BY-NC 4.0) and follows the publication model of SciELO Publishing Schema (SciELO PS) for publication in XML format.
You are free to:
- Share — copy and redistribute the material in any medium or format.
- Adapt — remix, transform, and build upon the material.
The licensor cannot revoke these freedoms as long as you follow the license terms.
Under the following terms:
Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- NonCommercial — You may not use the material for commercial purposes.
No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
Notices:
- You do not have to comply with the license for elements of the material in the public domain or where your use is permitted by an applicable exception or limitation.
- No warranties are given. The license may not give you all of the permissions necessary for your intended use. For example, other rights such as publicity, privacy, or moral rights may limit how you use the material.
Download PDF
