Peri-implant soft tissue augmentation with a porcine collagen matrix.
Abstract
A good amount and width of keratinized tissue around implants has been associated with better health periimplant, less bone loss and improved aesthetics. The purpose of this case was to evaluate a new porcine xenograft (collagen matrix) when used as an interpositional graft to increase the thickness of the peri-implant mucosa. Few studies using the collagen matrix as a substitute for subepithelial connective graft around implants are. The case involved an implant clinical at level of teeth 15 during placement of scar took the opportunity to swell the peri-implant mucosa with the collagen matrix. An increase in thickness of 1.5 mm while maintaining the amount of keratinized mucosa 4mm was obtained. We conclude that the collagen matrix of porcine origin is a good alternative to increase the thickness of the peri-implant mucosa and reduce morbidity, be easy to handle and easy to suture.
Keywords: Aesthetics, dental implant, peri-implant tissue, peri-implant mucosa thickness, peri-implant health.
Aumento de tejido blando periimplantario con matriz de colágeno porcino. Reporte de caso clínico
Una buena cantidad y grosor de tejido queratinizado alrededor de implantes ha sido asociado con una mejor salud periimplantaria, menos pérdida ósea y una mejora en la estética. El propósito de este caso clínico fue evaluar un nuevo xenoinjerto de origen porcino (matriz de colágeno) al ser utilizada como un injerto interposicional para aumentar el grosor de la mucosa periimplantaria. Son pocos los estudios que utilizan la matriz de colágeno como sustituto del injerto conectivo subepitelial alrededor de implantes. El caso clínico incluyó un implante a nivel de la pieza 15, en el cual durante la colocación del pilar de cicatrización se aprovechó para engrosar la mucosa periimplantaria utilizando una matriz de colágeno. Se obtuvo un aumento de grosor de 1,5mm manteniéndose la cantidad de mucosa queratinizada de 4mm. Se concluyó que la matriz de colágeno de origen porcino es una buena alternativa para aumentar el grosor de la mucosa periimplantaria, además de reducir la morbilidad, ser de fácil manejo y de fácil sutura.
Palabras clave: Estética, implante dental, tejido periimplantario, grosor mucosa periimplantaria, salud periimplantaria.
References
2. Valderhaug J, Birkeland JM. Periodontal conditions in patients 5 years following insertion of fixed prostheses. Pocket depth and loss of attachment. J Oral Rehab 1976; 3: 237–43.
3. Lorenzo R, García V, Orsini M, Martin C, Sanz M. Clinical efficacy of a xenogeneic collagen matrix in augmenting keratinized mucosa around implants: a randomized controlled prospective clinical trial. Clin Oral Impl Res 2012; 23: 316-24.
4. Grusovin MG, Coulthard P, Worthington HV, Esposito M. Maintaining and recovering soft tissue health around dental implants: a Cochrane systematic review of randomised controlled clinical trials. European J Oral Implantol 2008; 1: 11–22.
5. Palacci P, Nowzari H. Soft tissue enhancement around dental implants. Periodontol 2000. 2008; 47: 113-132.
6. Schallhorn RA, Charles A, Clem D, McClain PK, Newman MG. Practice-Based Case Series Evaluation of a Porcine Collagen Matrix to Thicken Soft Tissue, Increase Keratinized Tissue and Improve Esthetics Around Existing Dental Implants. Clin Adv Periodontics 2012: 2; 1-7.
7. Mandelaris GA, Lu M, Rosenfeld AL. The Use of a Xenogeneic Collagen Matrix as an Interpositional Soft-Tissue Graft to Enhance Peri-Implant Soft-Tissue Outcomes: A Clinical Case Report and Histologic Analysis. Clin Adv Periodontics 2011; 1: 193-8.
8. Simion M, Rocchietta I, Fontana F, Dellavia C .Evaluation of a resorbable collagen matrix infused with rhPDGF-BB in peri-implant soft tissue: A preliminary report with 3.5 years of observation. Int J Periodontics Restorative Dent 2012; 32: 273-82.
9. Jung RE, Hurzeler MB, Thoma DS, Khraisat A, Hammerle CH. Local tolerance and efficiency of two prototype collagen matrices to increase the width of keratinized tissue. J Clin Periodontol 2011; 38: 173–9.
10. McGuire MK, Scheyer ET. Xenogeneic Collagen Matrix With Coronally Advanced Flap Compared to Connective Tissue With Coronally Advanced Flap for the Treatment of Dehiscence-Type Recession Defects. J Periodontol 2010; 81: 1108-17.
11. Castro Y, Grados S. Porcine collagen matrix for treating gingival recession. Randomized clinical trial. J Oral Res. 2014; 3(1): 23-8.
12. Calderón IC, Castro YR. Cirugía periodontal e implantológica. Paso a paso. 1era edición. Lima: Universidad Nacional Mayor de San Marcos; 2013.
13. Chung DM, Oh TJ, Shotwell JL, Misch CE, Wang HL. Significance of Keratinized Mucosa in Maintenance of Dental Implants With Different Surfaces. J Periodontol 2006; 77: 1410-20.
14. Rochietta I, Schupbach P, Ghezzi C, Moschera E, Simion M. Soft tissue integration of a porcine collagen membrane: an experimental study in pigs. Int J Periodontics Restorative Dent 2012; 32: e34-e40.
15. Sanz M, Lorenzo R, Aranda JJ, Conchita M, Orsini M. Clinical evaluation of a new collagen matrix (Mucografts prototype) to enhance the width of keratinized tissue in patients with fixed prosthetic restorations: a randomized prospective clinical trial. J Clin Periodontol 2009; 36: 868-76.
16. Wei PC, Laurell L, Geivelis M, Lingen MW, Maddalozzo D. Acellular dermal matrix allografts to achieve increased attached gingiva. Part 1. A clinical study. J Periodontol 2000; 71: 1297–305.
17. Park JB. Increasing the width of keratinized mucosa around endosseous implant using acellular dermal matrix allograft. Implant Dent 2006; 15: 275–81.
18. Thoma DS, Jung RE, Schneider D, Cochran DL, Ender A, Jones AA, Görlach C, Uebersax L, Graf-Hausner U, Hämmerle CH. Soft tissue volume augmentation by the use of collagen-based matrices: a volumetric analysis. J Clin Periodontol 2010; 37: 659-66.
19. Thoma DS, Hämmerle CH, Cochran DL, Jones AA, Görlach C, Uebersax L, Mathes S, Graf-Hausner U, Jung RE. Soft tissue volume augmentation by the use of collagen-based matrices in the dog mandible – a histological analysis. J Clin Periodontol 2011; 38: 1063-70.
20. Rothamel D, Schwarz F, Sager M, Herten M, Sculean A, Becker J. Biodegradation of differently cross-linked collagen membranes: an experimental study in the rat. Clin Oral Impl Res 2005; 16: 369–78.
This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. © 2024.
