Efficacy of Collagen Matrix (Mucograft® and Mucoderm®) Versus Free Gingival Graft to Enhance the Width of Keratinized Tissue Around Implants
Abstract
Amaç: Keratinize dişeti dokusu yetersizliği implantın sağlığı için önemli faktörlerden biridir. Bu çalışmanın amacı, serbest dişeti grefti (SDG) ile karşılaştırıldığında diş implantlarının etrafındaki keratinize dokuyu arttırmayı amaçlayan kolajen matriks türevlerini (Mucograft® ve Mucoderm®) test etmektir.
Gereç ve Yöntem: Çalışmaya 36 implant ve 18 hasta dahil edildi. Katılımcılar rastgele üç gruba ayrıldı, SDG kontrol grubuna (CG), Mucograft® test grubu 1’e (TG1) ve Mucoderm® test grubu 2'ye (TG2) uygulandı. Plak indeksi (PI), gingival indeks (GI), sondlamada kanama (BoP), cep derinliği (PD), keratinize mukozanın genişliği (KMW) ve keratinize mukoza kalınlığı (KMT) ölçüldü. Tam ağız PI, GI, PD değerleri elde edildi. Bu ölçümler başlangıçta, ameliyattan sonra 1., 3. ve 6. aylarda kaydedildi.
Bulgular: Grup içi ve gruplar arası ogmentasyon alanı için klinik parametreler açısından; Operasyon bölgesinin PI, GI, BoP, KMW, başlangıç değerleri ile 1., 3. ve 6. aylardaki değerler arasında istatistiksel olarak anlamlı fark görüldü (p <0.05). Başlangıç PI, GI, BoP değerleri 1., 3. ve 6. aylara göre anlamlı derecede yüksek olduğu görüldü. Bu durum tüm gruplar için geçerlidir. Tüm gruplar için, başlangıç KMW değerleri 1., 3. ve 6. aylara göre anlamlı derecede düşük bulundu. KMT açısından gruplar arasında istatistiksel olarak anlamlı bir fark yoktur.
Sonuç: Farklı greft alternatifleri ile yapılan yumuşak doku ogmentasyonlarında peri-implant keratinize diş eti genişliği değerleri başlangıca göre artmıştır. Otojen greft (FGG) ve domuz kaynaklı kollajen greft materyalleri (Mucograft ve Mucoderm) arasında büyük farklar gözlenmedi. Keratinize diş eti kazancının diş eti sağlığı üzerindeki olumlu etkisi gözlendi.
Supporting Institution
Gazi Üniversitesi Bilimsel Araştırma Projeleri Destek Birimi
Project Number
03/2013-04
References
- 1. Wang Y, Zhang Y, Miron RJ. Health, maintenance, and recovery of soft tissues around implants. Clinical implant dentistry and related research 2016;18:618-634.
- 2. Lin G-H, Madi IM. Soft-tissue conditions around dental implants: a literature review. Implant Dentistry 2019;28:138-143.
- 3. Pranskunas M, Poskevicius L, Juodzbalys G, Kubilius R, Jimbo R. Influence of peri-implant soft tissue condition and plaque accumulation on peri-implantitis: a systematic review. Journal of oral & maxillofacial research 2016;7.
- 4. Lang NP, Löe H. The relationship between the width of keratinized gingiva and gingival health. Journal of periodontology 1972;43:623-627.
- 5. Sanz M, Lorenzo R, Aranda JJ, Martin C, Orsini M. Clinical evaluation of a new collagen matrix (Mucograft® prototype) to enhance the width of keratinized tissue in patients with fixed prosthetic restorations: a randomized prospective clinical trial. Journal of clinical periodontology 2009;36:868-876.
- 6. Wennström J, Bengazi F, Lekholm U. The influence of the masticatory mucosa on the peri‐implant soft tissue condition. Clinical oral implants research 1994;5:1-8.
- 7. Toljanic JA, Ward CB, Gewerth ME, Banakis ML. A Longitudinal Clinical Comparison Plaque‐Induced Inflammation Between Gingival and Peri‐Implant Soft Tissues in the Maxilla. Journal of periodontology 2001;72:1139-1145.
- 8. Lin GH, Chan HL, Wang HL. The significance of keratinized mucosa on implant health: a systematic review. Journal of periodontology 2013;84:1755-1767.
- 9. Sato N. Periodontal surgery: a clinical atlas: Quintessence Publishing Company, 2000.
- 10. Thoma DS, Naenni N, Figuero E, Hämmerle CH, Schwarz F, Jung RE, et al. Effects of soft tissue augmentation procedures on peri‐implant health or disease: A systematic review and meta‐analysis. Clinical oral implants research 2018;29:32-49.
- 11. Egles C, Shamis Y, Mauney JR, Volloch V, Kaplan DL, Garlick JA. Denatured collagen modulates the phenotype of normal and wounded human skin equivalents. Journal of investigative dermatology 2008;128:1830-1837.
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- 15. Zigdon H, Machtei EE. The dimensions of keratinized mucosa around implants affect clinical and immunological parameters. Clinical Oral Implants Research 2008;19:387-392.
- 16. Warrer K, Buser D, Lang N, Karring T. Plaque‐induced peri‐implantitis in the presence or absence of keratinized mucosa. An experimental study in monkeys. Clinical oral implants research 1995;6:131-138.
- 17. Bouri Jr A, Bissada N, Al-Zahrani MS, Faddoul F, Nouneh I. Width of keratinized gingiva and the health status of the supporting tissues around dental implants. International Journal of Oral & Maxillofacial Implants 2008;23.
- 18. Weber H-P, Cochran DL. The soft tissue response to osseointegrated dental implants. The Journal of prosthetic dentistry 1998;79:79-89.
- 19. Fu J-H, Su C-Y, Wang H-L. Esthetic soft tissue management for teeth and implants. Journal of Evidence Based Dental Practice 2012;12:129-142.
- 20. Greenstein G, Cavallaro J. The clinical significance of keratinized gingiva around dental implants. Compend Contin Educ Dent 2011;32:24-31.
- 21. McGuire MK, Scheyer ET. Randomized, controlled clinical trial to evaluate a xenogeneic collagen matrix as an alternative to free gingival grafting for oral soft tissue augmentation. Journal of periodontology 2014;85:1333-1341.
- 22. Lee K-H, Kim B-O, Jang H-S. Clinical evaluation of a collagen matrix to enhance the width of keratinized gingiva around dental implants. Journal of periodontal & implant science 2010;40:96-101.
- 23. Vignoletti F, Nuñez J, Discepoli N, De Sanctis F, Caffesse R, Muñoz F, et al. Clinical and histological healing of a new collagen matrix in combination with the coronally advanced flap for the treatment of Miller class‐I recession defects: An experimental study in the minipig. Journal of Clinical Periodontology 2011;38:847-855.
- 24. 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. Clinical oral implants research 2012;23:316-324.
- 25. Park J-B. Increasing the width of keratinized mucosa around endosseous implant using acellular dermal matrix allograft. Implant dentistry 2006;15:275-281.
- 26. Scarano A, Barros RR, Iezzi G, Piattelli A, Novaes Jr AB. Acellular dermal matrix graft for gingival augmentation: a preliminary clinical, histologic, and ultrastructural evaluation. Journal of periodontology 2009;80:253-259.
- 27. Schlee M, Esposito M. Human dermis graft versus autogenous connective tissue grafts for thickening soft tissue and covering multiple gingival recessions: 6-month results from a preference clinical trial. European journal of oral implantology 2011;4.
- 28. Strub J. The role of attached gingiva in the health of peri-implant tissue in dogs. 1. Clinical findings. Int J Periodontics Restorative Dent 1991;11:317-333.
- 29. Hämmerle C, Schou S, Holmstrup P, Hjorting‐hansen E, Lang N. Plaque‐induced marginal tissue reactions of osseointegrated oral implants: a review of the literature. Clinical oral implants research 1992;3:149-161.
- 30. Yeung S. Biological basis for soft tissue management in implant dentistry. Australian dental journal 2008;53:S39-S42.
- 31. Schrott AR, Jimenez M, Hwang JW, Fiorellini J, Weber HP. Five‐year evaluation of the influence of keratinized mucosa on peri‐implant soft‐tissue health and stability around implants supporting full‐arch mandibular fixed prostheses. Clinical oral implants research 2009;20:1170-1177.
- 32. Pontoriero R, Tonelli M, Carnevale G, Mombelli A, Nyman S, Lang N. Experimentally induced peri‐implant mucositis. A clinical study in humans. Clinical oral implants research 1994;5:254-259.
- 33. Lekholm U, Ericsson I, Adell R, Slots J. The condition of the soft tissues at tooth and fixture abutments supporting fixed bridges A microbiological and histological study. Journal of clinical periodontology 1986;13:558-562.
- 34. Thoma DS, Benić GI, Zwahlen M, Hämmerle CH, Jung RE. A systematic review assessing soft tissue augmentation techniques. Clinical oral implants research 2009;20:146-165.
Efficacy of Collagen Matrix (Mucograft® and Mucoderm®) Versus Free Gingival Graft to Enhance the Width of Keratinized Tissue Around Implants
Abstract
Aim: Keratinized gingival tissue insufficiency is one of the important factors for implant survival. The purposed of this study was to test collagen matrices (Mucograft® and Mucoderm®) aimed to increase keratinized tissue around dental implants when compared with free gingival graft (FGG).
Material and Method: Eighteen patients with 36 implants were included in the study. Participants were divided randomly into three groups, FGG were applied to the control group (CG), Mucograft® was applied test group 1 (TG1) and Mucoderm® was applied the test group 2 (TG2). Plaque index (PI), gingival index (GI), bleeding on probing (BoP), Probing depth (PD), the width of the keratinized mucosa (KMW) and thickness of keratinized mucosa (KMT) at augmentation site were measured. PI, GI, PD values of full mouth were obtained. These measurements were recorded at baseline, 1st, 3rd and 6th months after surgery.
Results: In the terms of clinical parameters for augmentation area within and between groups; There is a statistically significant difference between the PI, GI, BoP, KMW, baseline values of the augmentation site and the values at the 1st, 3rd and 6th months (p <0.05). Baseline PI, GI, BoP values were found to be significantly higher than at 1st, 3rd and 6th months. This situation is valid for all groups. For all groups, baseline KMW values were found to be significantly lower than at 1st, 3rd and 6th months. There is no statistically significant difference between groups, in term of KMT.
Conclusions: In soft tissue augmentations made with different graft alternatives, the peri-implant keratinized gingiva width values increased compared to the beginning. No major differences were observed between autogenous graft (FGG) and porcine collagen graft materials (Mucograft and Mucoderm). The positive effect of this keratinized gingiva gain on gingival health was observed.
Project Number
03/2013-04
References
- 1. Wang Y, Zhang Y, Miron RJ. Health, maintenance, and recovery of soft tissues around implants. Clinical implant dentistry and related research 2016;18:618-634.
- 2. Lin G-H, Madi IM. Soft-tissue conditions around dental implants: a literature review. Implant Dentistry 2019;28:138-143.
- 3. Pranskunas M, Poskevicius L, Juodzbalys G, Kubilius R, Jimbo R. Influence of peri-implant soft tissue condition and plaque accumulation on peri-implantitis: a systematic review. Journal of oral & maxillofacial research 2016;7.
- 4. Lang NP, Löe H. The relationship between the width of keratinized gingiva and gingival health. Journal of periodontology 1972;43:623-627.
- 5. Sanz M, Lorenzo R, Aranda JJ, Martin C, Orsini M. Clinical evaluation of a new collagen matrix (Mucograft® prototype) to enhance the width of keratinized tissue in patients with fixed prosthetic restorations: a randomized prospective clinical trial. Journal of clinical periodontology 2009;36:868-876.
- 6. Wennström J, Bengazi F, Lekholm U. The influence of the masticatory mucosa on the peri‐implant soft tissue condition. Clinical oral implants research 1994;5:1-8.
- 7. Toljanic JA, Ward CB, Gewerth ME, Banakis ML. A Longitudinal Clinical Comparison Plaque‐Induced Inflammation Between Gingival and Peri‐Implant Soft Tissues in the Maxilla. Journal of periodontology 2001;72:1139-1145.
- 8. Lin GH, Chan HL, Wang HL. The significance of keratinized mucosa on implant health: a systematic review. Journal of periodontology 2013;84:1755-1767.
- 9. Sato N. Periodontal surgery: a clinical atlas: Quintessence Publishing Company, 2000.
- 10. Thoma DS, Naenni N, Figuero E, Hämmerle CH, Schwarz F, Jung RE, et al. Effects of soft tissue augmentation procedures on peri‐implant health or disease: A systematic review and meta‐analysis. Clinical oral implants research 2018;29:32-49.
- 11. Egles C, Shamis Y, Mauney JR, Volloch V, Kaplan DL, Garlick JA. Denatured collagen modulates the phenotype of normal and wounded human skin equivalents. Journal of investigative dermatology 2008;128:1830-1837.
- 12. Ainamo J, Bay I. Problems and proposals for recording gingivitis and plaque. International dental journal 1975;25:229.
- 13. Silness J, Löe H. Periodontal disease in pregnancy II. Correlation between oral hygiene and periodontal condition. Acta odontologica scandinavica 1964;22:121-135.
- 14. Löe H, Silness J. Periodontal disease in pregnancy I. Prevalence and severity. Acta odontologica scandinavica 1963;21:533-551.
- 15. Zigdon H, Machtei EE. The dimensions of keratinized mucosa around implants affect clinical and immunological parameters. Clinical Oral Implants Research 2008;19:387-392.
- 16. Warrer K, Buser D, Lang N, Karring T. Plaque‐induced peri‐implantitis in the presence or absence of keratinized mucosa. An experimental study in monkeys. Clinical oral implants research 1995;6:131-138.
- 17. Bouri Jr A, Bissada N, Al-Zahrani MS, Faddoul F, Nouneh I. Width of keratinized gingiva and the health status of the supporting tissues around dental implants. International Journal of Oral & Maxillofacial Implants 2008;23.
- 18. Weber H-P, Cochran DL. The soft tissue response to osseointegrated dental implants. The Journal of prosthetic dentistry 1998;79:79-89.
- 19. Fu J-H, Su C-Y, Wang H-L. Esthetic soft tissue management for teeth and implants. Journal of Evidence Based Dental Practice 2012;12:129-142.
- 20. Greenstein G, Cavallaro J. The clinical significance of keratinized gingiva around dental implants. Compend Contin Educ Dent 2011;32:24-31.
- 21. McGuire MK, Scheyer ET. Randomized, controlled clinical trial to evaluate a xenogeneic collagen matrix as an alternative to free gingival grafting for oral soft tissue augmentation. Journal of periodontology 2014;85:1333-1341.
- 22. Lee K-H, Kim B-O, Jang H-S. Clinical evaluation of a collagen matrix to enhance the width of keratinized gingiva around dental implants. Journal of periodontal & implant science 2010;40:96-101.
- 23. Vignoletti F, Nuñez J, Discepoli N, De Sanctis F, Caffesse R, Muñoz F, et al. Clinical and histological healing of a new collagen matrix in combination with the coronally advanced flap for the treatment of Miller class‐I recession defects: An experimental study in the minipig. Journal of Clinical Periodontology 2011;38:847-855.
- 24. 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. Clinical oral implants research 2012;23:316-324.
- 25. Park J-B. Increasing the width of keratinized mucosa around endosseous implant using acellular dermal matrix allograft. Implant dentistry 2006;15:275-281.
- 26. Scarano A, Barros RR, Iezzi G, Piattelli A, Novaes Jr AB. Acellular dermal matrix graft for gingival augmentation: a preliminary clinical, histologic, and ultrastructural evaluation. Journal of periodontology 2009;80:253-259.
- 27. Schlee M, Esposito M. Human dermis graft versus autogenous connective tissue grafts for thickening soft tissue and covering multiple gingival recessions: 6-month results from a preference clinical trial. European journal of oral implantology 2011;4.
- 28. Strub J. The role of attached gingiva in the health of peri-implant tissue in dogs. 1. Clinical findings. Int J Periodontics Restorative Dent 1991;11:317-333.
- 29. Hämmerle C, Schou S, Holmstrup P, Hjorting‐hansen E, Lang N. Plaque‐induced marginal tissue reactions of osseointegrated oral implants: a review of the literature. Clinical oral implants research 1992;3:149-161.
- 30. Yeung S. Biological basis for soft tissue management in implant dentistry. Australian dental journal 2008;53:S39-S42.
- 31. Schrott AR, Jimenez M, Hwang JW, Fiorellini J, Weber HP. Five‐year evaluation of the influence of keratinized mucosa on peri‐implant soft‐tissue health and stability around implants supporting full‐arch mandibular fixed prostheses. Clinical oral implants research 2009;20:1170-1177.
- 32. Pontoriero R, Tonelli M, Carnevale G, Mombelli A, Nyman S, Lang N. Experimentally induced peri‐implant mucositis. A clinical study in humans. Clinical oral implants research 1994;5:254-259.
- 33. Lekholm U, Ericsson I, Adell R, Slots J. The condition of the soft tissues at tooth and fixture abutments supporting fixed bridges A microbiological and histological study. Journal of clinical periodontology 1986;13:558-562.
- 34. Thoma DS, Benić GI, Zwahlen M, Hämmerle CH, Jung RE. A systematic review assessing soft tissue augmentation techniques. Clinical oral implants research 2009;20:146-165.
Details
| Primary Language | English |
|---|---|
| Subjects | Dentistry |
| Journal Section | Araştırma Makalesi |
| Authors | |
| Project Number | 03/2013-04 |
| Publication Date | May 25, 2021 |
| Submission Date | January 12, 2021 |
| Published in Issue | Year 2021 Volume: 10 Issue: 2 |
