Palatal wound healing using a xenogeneic collagen matrix – histological outcomes of a randomized controlled clinical trial

Abstract

AIM The aim of this study was to test whether or not a collagen matrix can improve early wound healing compared to spontaneous healing based on histological and immunohistologic analyses. METHODS In 20 volunteers, 6 mm punch biopsies were harvested at the palate. A xenogeneic collagen matrix (XCM) was sutured in one site; the other one was left untreated (control). Biopsies with a diameter of 8 mm were subsequently obtained at 4, 8, 15 and 29 days and histological and immunohistologic analyses were performed. RESULTS At day 4, wound bed keratinization amounted to 12.4 ± 7.5% (control) and 18.0 ± 10.2% (XCM). This increased up to day 8 (19.7 ± 25.5% control; 29.1 ± 8.0% XCM) and reached complete keratinization at day 15 in both groups. The quantitative analyses of the superficial compartment measured an increase in the amount of granulation tissue (32-88% control; 14-41% XCM) from day 4 to day 8. Angiogenesis was first detected at 8 days. At day 29, the amount of connective tissue in all compartments reached values similar to the native tissue at baseline. CONCLUSIONS The application of a XCM as a wound dressing on palatal wounds might be beneficial in the early stages of wound healing. Further research with a larger sample size is needed to confirm these results. CLINICAL RELEVANCEScientific rationale for the study: Collagen matrices (CM) were developed to increase the width of keratinized tissue around teeth and implants. This study presents the histologic analysis of the early healing of a xenogeneic collagen matrix (XCM) compared to a spontaneously healing experimental wound.Principal findings: At 4 and 8 days, the extent of the epithelial coverage was slightly greater for XCM sites than for control sites. Furthermore, at 4 days and at 8 days after surgery there was a lower amount of granulation tissue found at XCM sites. At 15 days, all experimental wounds presented a fully keratinized epithelium. Practical implications:The use of a xenogeneic collagen matrix as a palatal wound dressing may offer an accelerated wound healing at the early stages. 4ABSTRACT Aim: To test whether or not a collagen matrix can improve early wound healing compared to spontaneous healing based on histologic and immunohistologic analyses. Methods:In 20 volunteers, 6 mm punch biopsies were harvested at the palate. A xenogeneic collagen matrix (XCM) was sutured in one site; the other one was left untreated (control). Biopsies with a diameter of 8 mm were subsequently obtained at 4, 8, 15 and 29 days and histologic and immunohistologic analyses were performed.

Clinical and histologic evaluation of different approaches to gain keratinized tissue prior to implant placement in fully edentulous patients

“…These findings demonstrate that within a 3-month period, irrespective of the treatment modality, stable soft tissue conditions can be expected. This is in line with observations from previous in vivo studies comparing collagen matrices and sites healing spontaneously that demonstrated no differences at the respective study endpoints between 1 and 6 months [45,46].…”

How Thick Is the Oral Mucosa around Implants after Augmentation with Different Materials: A Systematic Review of the Effectiveness of Substitute Matrices in Comparison to Connective Tissue Grafts

“…These materials are mainly acellular matrices derived from xenogeneic or allogenic dermis and have several advantages including that the material is available almost indefinitely, a second surgical site can be avoided and the overall treatment time can be shortened. The harvesting of subepithelial connective tissue grafts is a demanding surgical technique and associated with considerable intra- and postoperative risks of bleeding, infection or necrosis [ 14 ].…”

Healing kinetics of oral soft tissue wounds treated with recombinant epidermal growth factor: Translation from a canine model

“…A total of 84 soft tissue wounds were experimentally created in 14 animals (n = 6/animal; Table S1) by adapting a previously reported defect model of the masticatory mucosa of the palate (Thoma, Sancho-Puchades, Ettlin, Hämmerle, & Jung, 2012;Thoma et al, 2016;Ayvazyan et al,2011;Figure 1a,b).…”