Comparison of two soft tissue substitutes for the treatment of gingival recession defects: an animal histological study

Abstract

Objectives:This study aimed to compare two different soft tissue replacement grafts in their ability to treat gingival recession defects and successfully integrate with the surrounding tissues.Methodology:Nine beagle dogs were included and followed up to 10 weeks. Sites for intervention were allocated to one of the grafting materials investigated. Treatment consisted of coronally advanced flap combined with one of the two soft tissue substitutes on a previous surgically created defect. Materials employed were porcine-derived acellular dermal matrix (ADM) [Novomatrix™ (Test)] and collagen-based matrix (CBM) [Mucograft® (Control)]. Animals were sacrificed at 2, 6, and 10 weeks postoperatively and compared using descriptive histology and histomorphometric outcomes.Results:Macroscopic findings were similar between test and control groups at all intervals. After 10 weeks, both groups demonstrated successful incorporation of the grafting materials without signs of rejection and with comparable tissue integration. The histomorphometric data were similar between groups at 2 weeks; however, the test group provided greater root coverage and increase in tissue thickness than the control at 6- and 10-weeks post surgically.Conclusions:Both porcine-derived ADM and CBM revealed similar histological outcomes with successful integration and absence of adverse events. Test group provided superior outcomes regarding root coverage and increase in tissue thickness.

Histomorphometric Comparison between Two Types of Acellular Dermal Matrix Grafts: A Mini Pig Animal Model Study

“…Wei et al suggested that it is not uncommon to find inflammatory infiltrate in clinically healthy gingiva but there was increased inflammatory infiltrate in the ADMG group that could imply either a foreign body reaction or extended reaction to the process of wound healing [ 43 , 44 ]. These findings were contradictory to the observations made by Suárez-López et al [ 44 , 45 ], where there was neither chronic inflammatory infiltrate nor necrotic tissue suggestive of favorable tissue reaction. In this study, there were no significant differences in the inflammatory infiltrate when compared among the three groups over each of the time intervals of follow-up.…”

“…A study conducted by Suárez-López et al [ 45 ] compared the histological outcomes between porcine-derived ADMG and collagen-based matrix (CBM) for the treatment of gingival recession in beagle dogs and the follow-up period included 2, 6, and 10 weeks’ post-surgical intervention. The degree of vascularization was calculated from the percentage of blood vessels in the region of interest (ROI) and there was reduced vascularization in CBM when compared to ADMG at all time intervals and the changes were statistically significant [ 44 , 45 ]. In this study, there was a consistent increase in the number of blood vessels per sample in both the allografts with the highest average in mADMG (collagen-based matrix) and in concordance with the observations from the abovementioned study.…”

Adsorption and Release of Growth Factors from Four Different Porcine-Derived Collagen Matrices

“…Proprietary tissue processing retains components such as fibrillar collagens (types I, II, III, V, XI, XXIV and XXVII) and collagen type VI, fibronectin, elastin, hyaluronan, and proteoglycans, all of which appear critical to maintaining biochemical and biomechanical tissue integrity. A recent in vivo study, performed in beagle dogs, has compared NCM and HADM for their ability to treat gingival recession defects [ 63 ]. Importantly, both porcine-derived collagen matrices revealed similar histological outcomes with successful integration and absence of adverse events.…”

Clinical and Histological Differences between Guided Tissue Regeneration with Acellular Dermal Matrix of Porcine Origin and Autologous Connective Tissue: An Animal Study

“…It is estimated that 2 mm of keratinized tissue with one millimeter of tissue inserted around the teeth along with good plaque control can prevent insertion loss and gingival recession [ 23 , 28 ]. When keratinized gingiva gain is necessary, acellular dermal collagen matrices seem to be a good option to consider, although studies are limited [ 25 ]. For that reason, the present study evaluated the thickness of the keratin layer and the thickness of the epithelial tissue obtained after the grafting of acellular matrices as well.…”

“…Recently, other techniques involving the use of various xenogeneic matrices have demonstrated safety, viability, and efficacy [ 22 , 23 , 24 ]. In this field, porcine acellular dermal collagen matrices are an option to be considered [ 25 ]; however, the number of studies that scientifically support their use in clinical practice, and that compare histological results, are few [ 26 ]. Therefore, the purpose of this study was to evaluate variations at clinical and histological levels in the keratinized tissue in surgical wounds after the use of regenerative techniques, including acellular dermal matrix of porcine origin (MD) compared to results achieved using ACTG.…”