Kai R Fischer1,2, Tiziano Testori3,4,5, Hannes Wachtel6,7, Sven Mühlemann8, Arndt Happe9,10, Massimo Del Fabbro11,12. 1. Department for Periodontology, Faculty of Health, Witten/Herdecke University, Witten, Germany. 2. Division for Periodontology & Peri-Implant Disease, University of Zurich, Zürich, Switzerland. 3. Department of Periodontics and Oral Medicine, University of Michigan, School of Dentistry, Ann Arbor, Michigan. 4. IRCCS Orthopedic Institute Galeazzi, Milan, Italy. 5. Private Practice, Como, Italy. 6. Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Medicine Charité, University of Berlin, Berlin, Germany. 7. Private Practice, München, Germany. 8. Clinic of Reconstructive Dentistry, University of Zurich, Switzerland. 9. Department of Oral and Maxillofacial Plastic Surgery and Implantology, University of Cologne, Köln, Germany. 10. Private Practice, Münster, Germany. 11. Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy. 12. Dental Clinic, IRCCS Orthopedic Institute Galeazzi, Milan, Italy.
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.
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.