Contour Changes Following Implant Placement and Concomitant Soft Tissue Augmentation Applying a Volume-Stable Collagen Matrix

Artzi, Zvi; Renert, Uri; Pirc, Miha; Netanely, Erez; Thoma, Daniel S.

doi:10.11607/prd.5840

“…It captures linear and profilometric changes in peri‐implant soft‐tissue dimensions over time following therapeutic intervention to achieve a desired clinical outcome (keratinised mucosa width, mucosal thickness and/or supracrestal tissue height gain) often to facilitate oral hygiene practice, to protect the underlying bone and to reduce the risk of peri‐implant disease onset. Examples of relevant measurements are as follows: Keratinized mucosa width changes using a calibrated periodontal probe (Golmayo et al, 2021) Mucosal thickness changes via transmucosal horizontal probing using a piercing instrument (e.g., endodontic spreader) or with digital imaging analysis after superimposition of standard tessellation language (STL) files or other advanced imaging methods (e.g., ultrasonography; Artzi et al, 2022; Chan et al, 2018; Couso‐Queiruga et al, 2021; Hutton et al, 2018). Supracrestal tissue height changes via transmucosal vertical probing using a piercing instrument or with digital imaging analysis after superimposition of STL files or other advanced imaging methods (e.g., ultrasonography; Chan et al, 2018; Eghbali et al, 2016; Puisys & Linkevicius, 2015; Thoma et al, 2016; Zeltner et al, 2017).…”

Section: Consensus Resultsmentioning

confidence: 99%

“…Among the mandatory outcomes in all BA trials, the consensus identified (i) assessment of surgical complications and adverse events, (e.g., ultrasonography;Artzi et al, 2022;Chan et al, 2018;Couso-Queiruga et al, 2021;Hutton et al, 2018).…”

mentioning

confidence: 99%

Relevant domains, core outcome sets and measurements for implant dentistry clinical trials: The Implant Dentistry Core Outcome Set and Measurement (ID‐COSM) international consensus report

Tonetti

¹

,

Sanz

²

,

Ávila‐Ortiz

³

et al. 2023

J Clinic Periodontology

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“…It captures linear and profilometric changes in peri‐implant soft‐tissue dimensions over time following therapeutic intervention to achieve a desired clinical outcome (keratinised mucosa width, mucosal thickness and/or supracrestal tissue height gain) often to facilitate oral hygiene practice, to protect the underlying bone and to reduce the risk of peri‐implant disease onset. Examples of relevant measurements are as follows: Keratinized mucosa width changes using a calibrated periodontal probe (Golmayo et al, 2021) Mucosal thickness changes via transmucosal horizontal probing using a piercing instrument (e.g., endodontic spreader) or with digital imaging analysis after superimposition of standard tessellation language (STL) files or other advanced imaging methods (e.g., ultrasonography; Artzi et al, 2022; Chan et al, 2018; Couso‐Queiruga et al, 2021; Hutton et al, 2018). Supracrestal tissue height changes via transmucosal vertical probing using a piercing instrument or with digital imaging analysis after superimposition of STL files or other advanced imaging methods (e.g., ultrasonography; Chan et al, 2018; Eghbali et al, 2016; Puisys & Linkevicius, 2015; Thoma et al, 2016; Zeltner et al, 2017).…”

Section: Consensus Resultsmentioning

confidence: 99%

“…The agreed description of each domain with its measurements follows. B. Mucosal thickness changes via transmucosal horizontal probing using a piercing instrument (e.g., endodontic spreader) or with digital imaging analysis after superimposition of standard tessellation language (STL) files or other advanced imaging methods (e.g., ultrasonography; Artzi et al, 2022;Chan et al, 2018;Couso-Queiruga et al, 2021;Hutton et al, 2018).…”

mentioning

confidence: 99%

Relevant domains, core outcome sets and measurements for implant dentistry clinical trials: The Implant Dentistry Core Outcome Set and Measurement (ID‐COSM) international consensus report

Tonetti

¹

,

Sanz

²

,

Ávila‐Ortiz

³

et al. 2023

Clinical Oral Implants Res

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Aim Lack of consistently reported outcomes limits progress in evidence‐based implant dentistry and quality of care. The objective of this initiative was to develop a core outcome set (COS) and measurements for implant dentistry clinical trials (ID‐COSM). Materials and Methods This Core Outcome Measures in Effectiveness Trials (COMET)‐registered international initiative comprised six steps over 24 months: (i) systematic reviews of outcomes reported in the last 10 years; (ii) international patient focus groups; (iii) a Delphi project with a broad range of stakeholders (care providers, clinical researchers, methodologists, patients and industry representatives); (iv) expert group discussions organizing the outcomes in domains using a theoretical framework and identifying the COSs; (v) identification of valid measurement systems to capture the different domains and (vi) final consensus and formal approval involving experts and patients. The methods were modified from the best practice approach following the Outcome Measures in Rheumatoid Arthritis Clinical Trial and COMET manuals. Results The systematic reviews and patient focus groups identified 754 (665 + 89, respectively) relevant outcome measures. After elimination of redundancies and duplicates, 111 were formally assessed in the Delphi project. By applying pre‐specified filters, the Delphi process identified 22 essential outcomes. These were reduced to 13 after aggregating alternative assessments of the same features. The expert committee organized them into four core outcome areas: (i) pathophysiology, (ii) implant/prosthesis lifespan, (iii) life impact and (iv) access to care. In each area, core outcomes were identified to capture both the benefits and harms of therapy. Mandatory outcome domains included assessment of surgical morbidity and complications, peri‐implant tissue health status, intervention‐related adverse events, complication‐free survival and overall patient satisfaction and comfort. Outcomes deemed mandatory in specific circumstances comprised function (mastication, speech, aesthetics and denture retention), quality of life, effort for treatment and maintenance and cost effectiveness. Specialized COSs were identified for bone and soft‐tissue augmentation procedures. The validity of measurement instruments ranged from international consensus (peri‐implant tissue health status) to early identification of important outcomes (patient‐reported outcomes identified by the focus groups). Conclusions The ID‐COSM initiative reached a consensus on a core set of mandatory outcomes for clinical trials in implant dentistry and/or soft tissue/bone augmentation. Adoption in future protocols and reporting on the respective domain areas by currently ongoing trials will contribute to improving evidence‐informed implant dentistry and quality of care.

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“…VCMX seems to render an alternative favorable solution for autogenous soft tissue augmentation, at least as shown in short-term observational studies (14)(15)(16)(17)(18)(19)(20). At this point, it would be important to evaluate the remodeled tissue at the stromal level to better understand the factors that could contribute to the increased soft tissue thickness.…”

Section: Introductionmentioning

confidence: 99%

Stromal cells associated with soft tissue augmentation by a volume stable collagen matrix (VCMX) are predominated by anti-inflammatory/reparative macrophages

Artzi

¹

,

Vered

²

,

Maymon-Gil

³

et al. 2023

Preprint

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Aim: To define immunophenotypes of stromal inflammatory and endothelial cells and fibroblasts 3-months post-augmentation of the peri-implant soft tissue using a porcine cross-linked collagen matrix (VCMX). Methods: Peri-implant soft tissue samples were obtained from 12 patients at the lining mucosa (LM) - masticatory mucosa (MM) junction, before and at 3-months post-augmentation. Immunohistochemical stains for identification of inflammatory cells [T (CD3) and B (CD20) lymphocytes, plasma cells (CD138)], macrophages (CD68-pro-inflammatory, CD163-anti-inflammatory/reparative), endothelial cells (CD31, CD34) and fibroblasts (CD90, TE-7), were performed. Differences in the mean positively-stained cells pre- and post-augmentation was analyzed by Wilcoxon Signed-Rank Test. Results: CD31+ endothelial cells showed increased mean numbers in MM2 compared to MM1 (p=0.025) and in LM2 compared to LM1 (p=0.047). CD163+ anti-inflammatory macrophages showed mean numbers in MM2 higher than MM1 (p=0.021) and in LM2 than LM1 (p=0.012). All other cell phenotypes showed insignificant changes between pre- and post-augmentation. Conclusion: This molecular study provided novel insight on the frequency of phenotypes of stromal cells in the wound healing process 3-months post-augmentation with VCMX, with anti-inflammatory CD163+ macrophages being predominant. This should be further investigated in order to find novel therapeutic approaches to modulate and promote the VCMX-related healing process. Clinical Relevance: The specific molecular information on selected stromal cells in patients treated with VCMX disclosed that the tissue composition of the lining and masticatory mucosa was not affected by the augmentation with a VCMX, while enhancement in reparative macrophage and endothelial cells were observed.

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Contour Changes Following Implant Placement and Concomitant Soft Tissue Augmentation Applying a Volume-Stable Collagen Matrix

Cited by 5 publications

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Relevant domains, core outcome sets and measurements for implant dentistry clinical trials: The Implant Dentistry Core Outcome Set and Measurement (ID‐COSM) international consensus report

Relevant domains, core outcome sets and measurements for implant dentistry clinical trials: The Implant Dentistry Core Outcome Set and Measurement (ID‐COSM) international consensus report

Relevant domains, core outcome sets and measurements for implant dentistry clinical trials: The Implant Dentistry Core Outcome Set and Measurement (ID‐COSM) international consensus report

Stromal cells associated with soft tissue augmentation by a volume stable collagen matrix (VCMX) are predominated by anti-inflammatory/reparative macrophages

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