Augmentation of keratinized tissue at tooth and implant sites by using autogenous grafts and collagen‐based soft‐tissue substitutes

Abstract

Aim: To investigate the effect of three treatment modalities on the gain of keratinized tissue (KT) at tooth and implant sites in dogs. Materials and Methods: In five dogs, the distal roots of the mandibular second, third and fourth premolars were extracted, while the mesial roots were maintained. After 2 months of healing, implants were placed with KT excision. After another 2 months of healing, free gingival grafts, collagen-based matrices and apically positioned flap only were applied. The height of KT was measured during implant placement, immediately before soft-tissue grafting and after 10, 30 and 60 days. Results: Two months after KT excision, spontaneous KT regrowth was greater at tooth sites than at implant sites (median, 2.0 mm vs. 1.1 mm). The outcomes of softtissue grafting at implant sites favoured the free gingival graft treatment, with a greater final median height (5.0-5.5 mm) and increase in KT (4.0-4.2 mm). Locations of the recipient sites significantly influenced KT regeneration at both tooth and implant sites. Conclusions: At implant sites, the free gingival graft treatment led to higher KT regeneration. At tooth sites, however, the differences between the three treatment modalities seemed clinically irrelevant.

Keratinized tissue gain after free gingival graft augmentation procedures around teeth and dental implants: A prospective observational study

“…These marked differences between groups could be explained by the reduced vascular supply and less fibroblasts present in peri‐implant tissues (Berglundh et al, 1991, 1994), which may jeopardize the first stages of healing and thus lead to a greater KTW reduction and more GS. However, in a recent preclinical investigation, no differences in KTW were observed after gingival augmentation with FGG at teeth and implant sites after 3 months (Thoma et al, 2019). One possible explanation for these contradictory outcomes could be the fact that, in their animal model, the same graft was used to treat the mucogingival defects of neighbouring implants and teeth, and thus, the graft healing process could have been different from that of our investigation, where implants and teeth were treated separately.…”

Dimensional changes in free epithelialized gingival/mucosal grafts at tooth and implant sites: A prospective cohort study

“…12,13 The use of apically positioned flaps (APFs) combined with free epithelialized gingival/mucosal grafts (FEGs) were suggested to predictably modify the periodontal/periimplant soft tissue phenotypes with the aim of augmenting KT and promoting long-term health. 13,14 It should be noted that these strategies have shown less favorable outcomes in terms of aesthetics (i.e., color match) 15 when compared to other interventions such as coronally advanced flaps in combination with other grafting approaches such as de-epithelialized grafts. 16 Furthermore, one of the notorious shortcomings associated with this technique is graft dimensional changes, which can eventually compromise the desired final outcome.…”

Osteoconductive Properties of a Volume-Stable Collagen Matrix in Rat Calvaria Defects: A Pilot Study

“…To overcome this limitation, a palate-derived connective tissue graft is used to regenerate the lost gingiva tissue, a process termed soft tissue augmentation [5,6]. To overcome the harvesting of the autografts, soft tissue substitutes were introduced to the field [7,8].…”