Use of a Collagen Matrix as a Substitute for Free Mucosal Grafts in Pre-Prosthetic Surgery: 1 Year Results From a Clinical Prospective Study on 15 Patients

Abstract

Background:The presence of keratinized tissue around dental implants is more than desirable either from a functional and aesthetic point of view, making soft tissue grafting a common practice in implant rehabilitation. Autogenous soft tissue grafting procedures are usually associated with high morbidity. Aim of this study was to assess the efficacy of a xenogeneic collagen matrix as a substitute for soft tissue grafting around dental implants.Methods:15 consecutive patients underwent a vestibuloplasty and grafting, both in the mandible and the maxilla, with a collagen matrix.Results:The primary endpoint was to evaluate the resorption of the graft along with the re-epithelization grafted area. The percentage of the resorption was 44,4%, with a mean gain in vestibular height of 3 mm. Secondary endpoints evaluated the clinical appearance, the hemostatic effect and the post-operative pain. All subjects referred minimal pain with no bleeding. No adverse reaction nor infection were noted.Conclusion:This study showed that the used collagen matrix can find major interest in those patients who need a greater aesthetic outcome as the matrix has a perfect integration with the surrounding tissues. Furthermore it is strongly recommended for those patients who can bear little pain.Clinical Significance:Post-operative morbidity of autologous grafts is the biggest concern of this type of surgery. The possibility to use a soft tissue substitute is a great achievement as morbidity decreases and bigger areas can be treated in a single surgery.The present study showed the efficacy of a collagen matrix as this kind of substitute.

The efficacy of a porcine collagen matrix in keratinized tissue augmentation: a 5-year follow-up study

“…The xenogeneic CM showed an ideal haemostatic effect with no excessive bleeding during surgery and no bleeding at all during post-operative period, similar to other techniques using absorbable collagen sponges in different kinds of treatments [ 31 ]. Furthermore, all grafted sites presented, when healing was completed, an optimal integration with the surrounding tissues, as stated by other authors in previous studies [ 15 – 17 ]. Rotundo an Pini-Prato observed the good esthetic of the CM also when used in the coverage of multiple gingival recession [ 32 ].…”

“…The surgical procedure, as already described in a previous study, consisted in a standard apically positioned flap with subsequent apposition of the CM, performed under local anesthesia [ 17 ]. At first, a midcrestal incision was performed in the residual keratinized band and a split thickness flap was raised.…”

“…So far, a number of studies have demonstrated that the Mucograft is reliable and comparable with free gingival graft for what concerns achievements in keratinized tissue augmentation around both teeth or dental implants [ 12 – 15 ]. Additional advantages are a lower patient morbidity due to the absence of a donor site and the high esthetic value, matching texture and color of the adjacent mucosa [ 11 , 15 – 17 ]. Concerns about long-term stability of this kind of procedure are more than reasonable, as the majority of papers in literature have short-term follow-ups (< 1 year), while just a few extend over this period.…”

3D Printing Approach in Dentistry: The Future for Personalized Oral Soft Tissue Regeneration

“…Moreover, histology analysis indicated a significant difference in comparison to the natural tissue [ 133 ]. To reduce scar retraction and enhance the healing process, a novel collagen matrix, Geistlich Mucograft ® (Geistlich Pharma AG, Wolhusen, Switzerland), was designed and evaluated as a replacement for autogenous tissue to increase the width of keratinized tissue and cover gingival recessions [ 134 , 135 , 136 , 137 , 138 ]. Clinical data indicated strong enhancement of the keratinized tissue width with similar outcomes in comparison to the FGG [ 139 , 140 , 141 , 142 ].…”

In Vitro Feasibility Analysis of a New Sutureless Wound-Closure System Based on a Temperature-Regulated Laser and a Transparent Collagen Membrane for Laser Tissue Soldering (LTS)

“…Wound patches based on xenogeneic collagen have already been identified as a reliable treatment option [ 5 , 6 ]. In this context, it has been shown that collagen as a biomaterial supports the wound healing process due to its non-inflammatory properties and excellent biocompatibility and additionally collagen materials can promote epithelial regeneration [ 5 , 7 , 8 , 9 ].…”