Soft tissue augmentation applying a collagenated porcine dermal matrix during second stage surgery: A prospective multicenter case series

Abstract

Background The achievement and preservation of an adequate amount of soft tissue around implants is a critical factor for the prognosis of the treatment. Purpose To evaluate the effectiveness of a porcine dermal matrix applied during second stage implant surgery for horizontal soft tissue augmentation and preservation of dimensional stability. Materials and Methods Twenty patients (mean age 50.2 ± 11.9 [SD] years) candidate to implant therapy and requiring soft tissue augmentation were recruited in four centers. Augmentation was performed in 24 cases. A porcine dermal matrix was placed into a buccal split‐thickness pouch during uncovering surgery. Silicone impressions were taken before surgery (T0), 2 weeks later at suture removal (T2), 6 months (T3), and 24 months (T4) post augmentation. Dimensional changes of soft tissue were evaluated using superimposition of digitalized study casts. Results Nineteen patients (23 implants) could be evaluated at 6 months and 13 patients (17 implants) at 24 months. After 6‐month follow‐up, there was a significant dimensional gain respect to baseline, averaging 0.83 ± 0.64 mm (P < .01). This did not change significantly at 24 months (0.77 ± 0.65 mm, P = .19). The gain was >0.5 mm in 65.2% and 64.7% of the cases, respectively. Soft tissue shrinkage averaged 34.2% ± 77.0% from T2 to T3 (P < .01) and did not change thereafter (P = .39). Shrinkage was more consistent in the posterior mandible than in the maxilla, but not significantly (P = .23 at 6‐month and .36 at 24‐month). No adverse events occurred. Conclusion Within the limitations of this prospective case series, the use of a porcine dermal matrix may provide consistent soft tissue augmentation that maintains up to 24‐month follow‐up, although graft shrinkage may occur in the first 6 months, depending on the location of surgery.

A 3-Year Prospective Study on a Porcine-Derived Acellular Collagen Matrix to Re-Establish Convexity at the Buccal Aspect of Single Implants in the Molar Area: A Volumetric Analysis

“…The mean increase in buccal soft tissue thickness in these studies ranged from 0.70 mm to 1.16 mm after 3 to 12 months of follow-up. One prospective study was found on OsteoBiol Derma Standard ® (Tecnoss, Giaveno, Italy) using the same volumetric measurement method as described in the present study [47]. An initial tissue gain of 1.57 mm was seen two weeks post-augmentation.…”

Biomimetic Aspects of Oral and Dentofacial Regeneration

“…The scaffold resorbs upon transplantation, leaving the ECM and functional fibroblasts which secrete appropriate growth factors, allowing faster healing of the tissue [237]. (B) Natural polymers and scaffolds Human-derived Acellular Dermal Matrices (ADM) are one of the more common scaffold materials which mimic ECM to provide a favourable environment for cell growth and growth factor exchange [238]. Similar scaffolds can be generated of xenogeneic origin like porcine graft, which showed positive outcomes as a scaffold [239].…”

“…However, their stiffness and fragility were seen to increase because they have been recently used mixed with non-resorbable polymers, (MMA)1-co-(HEMA)1 and (MA)3co-(HEA)2. As the synthetic grafts have limited biological interactions, they have to be impregnated (B) Natural polymers and scaffolds Human-derived Acellular Dermal Matrices (ADM) are one of the more common scaffold materials which mimic ECM to provide a favourable environment for cell growth and growth factor exchange [238]. Similar scaffolds can be generated of xenogeneic origin like porcine graft, which showed positive outcomes as a scaffold [239].…”

State of the Art on Biomaterials for Soft Tissue Augmentation in the Oral Cavity. Part I: Natural Polymers-Based Biomaterials

“…It is therefore clinically recommended a keratinized mucosa width of 2 mm, which is the same size that it is suggested for an adequate keratinized gingiva zone around the teeth [ 5 ]. When the mucosa thickness is higher than 2 mm, the human eye is no longer able to detect light reflection (translucency) differences of zirconia or titanium abutments underneath the soft tissue [ 6 ].…”

“…Buccal fat pad and free buccal mucosa grafts have also been proposed [ 1 ]. Thereby, an alternative treatment for the autogenous soft tissue graft is recommended based on the good clinical integration of collagen-based dermal matrices in implant and plastic periodontal surgery [ 6 ].…”