BackgroundWhen keratinized tissue width around dental implants is poorly represented, the clinician could resort to autogenous soft tissue grafting. Autogenous soft tissue grafting procedures are usually associated with a certain degree of morbidity. Collagen matrices could be used as an alternative to reduce morbidity and intra-operatory times. The aim of this study was to assess the efficacy of a xenogeneic collagen matrix as a substitute for soft tissue grafting around dental implants.MethodsFifteen consecutive patients underwent a vestibuloplasty and keratinized tissue reconstruction around dental implants, both in the mandible and the maxilla, with a porcine collagen matrix. The so obtained keratinized tissues were measured and evaluated after 6 months and 1, 4, and 5 years.ResultsThe average gain of keratinized tissue was 5.7 mm. After 6 months, it was observed a resorption of 37%, after 1 year 48%, and after 5 years 59%. The mean gain of keratinized tissue after 5 years was 2.4 mm. Hemostatic effect and post-operative pain were evaluated too. All subjects referred minimal pain with no bleeding. No adverse reaction nor infection was noted.ConclusionsThe present study showed the efficacy of a porcine collagen matrix in keratinized tissue augmentation. 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.

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 aim of this study is to report the effectiveness of a tongue flap for covering a large hard and soft tissue defect following cleft of the palate. A young patient diagnosed with acute lymphoblastic leukemia underwent a surgical reconstruction of the cleft palate by Le Fort I osteotomy and palatal closure utilizing a tongue flap. The flap provided sound and lasting closure after the surgery, and the patient successfully healed. Our goal is to present this unique case and highlight how postoperative results were good, safe, and predictable. We also hope to show that tongue transplantation as flap for hard and soft tissue reconstruction represents a valuable option in reconstruction, given the proper circumstances.

The aim of this study is to report the efficacy of a lingual pedicle flap for soft tissue pre-prosthetic surgery in implant rehabilitation. While it has been demonstrated that keratinized gingiva is an important factor for implant success, there remains a dearth of case reports concerning the use of a lingual pedicle flap to achieve this desired outcome in such a large reconstructive effort. For this case report, the patient underwent an anterior mandibular resection of an ameloblastoma and subsequent reconstruction, resulting in soft tissue loss. To satisfy the patient's desires, both functionally and esthetically, a bilateral rotated pedicled lingual flap was performed to augment keratinized tissue on the anterior mandibular ridge. An additional vestibuloplasty with two collagen matrices was also performed, and an acrylic splint was then applied to achieve better stabilization. The primary outcome was to evaluate the efficacy of this technique, which, until now, was used only for exposed root coverage. The site demonstrated excellent healing over time, even resulting in an excess of healthy and pink soft tissue, which later had to be corrected with a small gingivectomy. Although the patient reported slight discomfort for a few days after surgery, she was nonetheless pleased both with her ability to function and her appearance. The results of this study show that the bilateral rotated pedicled lingual flap is a viable technique for the correction of soft tissue defects in implant dentistry, providing a good amount of keratinized gingiva.