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Erschienen in: Clinical Oral Investigations 3/2018

18.09.2017 | Original Article

Volumetric and linear changes at dental implants following grafting with volume-stable three-dimensional collagen matrices or autogenous connective tissue grafts: 6-month data

verfasst von: Nadja Naenni, Stefan P. Bienz, Goran I. Benic, Ronald E. Jung, Christoph H. F. Hämmerle, Daniel S. Thoma

Erschienen in: Clinical Oral Investigations | Ausgabe 3/2018

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Abstract

Objectives

The objective of this study was to test whether or not soft tissue augmentation with a volume-stable collagen matrix (VCMX) leads to similar volume gain around dental implants compared to autogenous subepithelial connective tissue graft (SCTG).

Materials and methods

In 12 adult beagle dogs, immediate implants were placed with simultaneous guided bone regeneration. After 25–45 weeks, soft tissue augmentation was randomly performed using VCMX, SCTG, or a sham-operated control. Impressions were taken pre-op and post-op (tissue augmentation) and again at sacrifice after healing periods of 4, 8, and 24 weeks. They were then digitized to allow for superimposition. Values of linear and volumetric changes were calculated.

Results

The median increase (pre-op to post-op) in buccal volume measured 0.92 mm for VCMX, 1.47 mm for SCTG, and 0.24 mm for SH. The values (pre-op to sacrifice) were − 0.25 mm for VCMX, 0.52 mm for SCTG, and − 0.06 mm for group SH. The median ridge width 2 mm below the crest measured − 0.26 mm for VCMX, 0.53 mm for SCTG, and − 0.15 mm for SH (pre-op to sacrifice).

Conclusions

Volume augmentation using VCMX and SCTG resulted in an increase in ridge dimension (pre- to post-op). During the follow-up, the volume decreased in all three groups to a level close to the situation prior to surgery.

Clinical relevance

Soft tissue volume augmentation around dental implants is usually performed using the patient’s own tissue. This therapy is associated with an increased morbidity due to a second surgical site. Soft tissue volume at implant sites can be augmented using VCMX and SCTG. The gain on top of the ridge appears not to be stable during the follow-up in both groups.
Literatur
1.
Zurück zum Zitat Cardaropoli G, Araujo M, Lindhe J (2003) Dynamics of bone tissue formation in tooth extraction sites. An experimental study in dogs. J Clin Periodontol 30:809–818CrossRefPubMed Cardaropoli G, Araujo M, Lindhe J (2003) Dynamics of bone tissue formation in tooth extraction sites. An experimental study in dogs. J Clin Periodontol 30:809–818CrossRefPubMed
3.
Zurück zum Zitat Schropp L, Wenzel A, Kostopoulos L, Karring T (2003) Bone healing and soft tissue contour changes following single-tooth extraction: a clinical and radiographic 12-month prospective study. Int J Periodontics Restorative Dent 23:313–323PubMed Schropp L, Wenzel A, Kostopoulos L, Karring T (2003) Bone healing and soft tissue contour changes following single-tooth extraction: a clinical and radiographic 12-month prospective study. Int J Periodontics Restorative Dent 23:313–323PubMed
4.
Zurück zum Zitat Christensen DK, Karoussis IK, Joss A, Hammerle CH, Lang NP (2003) Simultaneous or staged installation with guided bone augmentation of transmucosal titanium implants. A 3-year prospective cohort study. Clin Oral Implants Res 14:680–686CrossRefPubMed Christensen DK, Karoussis IK, Joss A, Hammerle CH, Lang NP (2003) Simultaneous or staged installation with guided bone augmentation of transmucosal titanium implants. A 3-year prospective cohort study. Clin Oral Implants Res 14:680–686CrossRefPubMed
8.
Zurück zum Zitat Langer B, Calagna L (1980) The subepithelial connective tissue graft. J Prosthet Dent 44:363–367CrossRefPubMed Langer B, Calagna L (1980) The subepithelial connective tissue graft. J Prosthet Dent 44:363–367CrossRefPubMed
9.
Zurück zum Zitat Langer B, Calagna LJ (1982) The subepithelial connective tissue graft. A new approach to the enhancement of anterior cosmetics. Int J Periodontics Restorative Dent 2:22–33PubMed Langer B, Calagna LJ (1982) The subepithelial connective tissue graft. A new approach to the enhancement of anterior cosmetics. Int J Periodontics Restorative Dent 2:22–33PubMed
10.
Zurück zum Zitat Pizzo D (2002) The connective tissue graft: a comparative clinical evaluation of wound healing at the palatal donor site. A preliminary study. J Clin Periodontol 29:848–854CrossRefPubMed Pizzo D (2002) The connective tissue graft: a comparative clinical evaluation of wound healing at the palatal donor site. A preliminary study. J Clin Periodontol 29:848–854CrossRefPubMed
11.
Zurück zum Zitat Jepsen K, Jepsen S, Zucchelli G, Stefanini M, de Sanctis M, Baldini N, Greven B, Heinz B, Wennstrom J, Cassel B, Vignoletti F, Sanz M (2013) Treatment of gingival recession defects with a coronally advanced flap and a xenogeneic collagen matrix: a multicenter randomized clinical trial. J Clin Periodontol 40:82–89. https://doi.org/10.1111/jcpe.12019 CrossRefPubMed Jepsen K, Jepsen S, Zucchelli G, Stefanini M, de Sanctis M, Baldini N, Greven B, Heinz B, Wennstrom J, Cassel B, Vignoletti F, Sanz M (2013) Treatment of gingival recession defects with a coronally advanced flap and a xenogeneic collagen matrix: a multicenter randomized clinical trial. J Clin Periodontol 40:82–89. https://​doi.​org/​10.​1111/​jcpe.​12019 CrossRefPubMed
12.
Zurück zum Zitat Schmitt CM, Moest T, Lutz R, Wehrhan F, Neukam FW, Schlegel KA (2016) Long-term outcomes after vestibuloplasty with a porcine collagen matrix (Mucograft(R) ) versus the free gingival graft: a comparative prospective clinical trial. Clin Oral Implants Res 27:e125–e133. https://doi.org/10.1111/clr.12575 CrossRefPubMed Schmitt CM, Moest T, Lutz R, Wehrhan F, Neukam FW, Schlegel KA (2016) Long-term outcomes after vestibuloplasty with a porcine collagen matrix (Mucograft(R) ) versus the free gingival graft: a comparative prospective clinical trial. Clin Oral Implants Res 27:e125–e133. https://​doi.​org/​10.​1111/​clr.​12575 CrossRefPubMed
13.
15.
Zurück zum Zitat Rebele SF, Zuhr O, Schneider D, Jung RE, Hurzeler MB (2014) Tunnel technique with connective tissue graft versus coronally advanced flap with enamel matrix derivative for root coverage: a RCT using 3D digital measuring methods. Part II Volumetric studies on healing dynamics and gingival dimensions. J Clin Periodontol 41:593–603. https://doi.org/10.1111/jcpe.12254 CrossRefPubMed Rebele SF, Zuhr O, Schneider D, Jung RE, Hurzeler MB (2014) Tunnel technique with connective tissue graft versus coronally advanced flap with enamel matrix derivative for root coverage: a RCT using 3D digital measuring methods. Part II Volumetric studies on healing dynamics and gingival dimensions. J Clin Periodontol 41:593–603. https://​doi.​org/​10.​1111/​jcpe.​12254 CrossRefPubMed
19.
Zurück zum Zitat Mathes SH, Wohlwend L, Uebersax L, von Mentlen R, Thoma DS, Jung RE, Gorlach C, Graf-Hausner U (2010) A bioreactor test system to mimic the biological and mechanical environment of oral soft tissues and to evaluate substitutes for connective tissue grafts. Biotechnol Bioeng 107:1029–1039. https://doi.org/10.1002/bit.22893 CrossRefPubMed Mathes SH, Wohlwend L, Uebersax L, von Mentlen R, Thoma DS, Jung RE, Gorlach C, Graf-Hausner U (2010) A bioreactor test system to mimic the biological and mechanical environment of oral soft tissues and to evaluate substitutes for connective tissue grafts. Biotechnol Bioeng 107:1029–1039. https://​doi.​org/​10.​1002/​bit.​22893 CrossRefPubMed
20.
Zurück zum Zitat Thoma DS, Zeltner M, Hilbe M, Hammerle CH, Husler J, Jung RE (2016) Randomized controlled clinical study evaluating effectiveness and safety of a volume-stable collagen matrix compared to autogenous connective tissue grafts for soft tissue augmentation at implant sites. J Clin Periodontol 43:874–885. https://doi.org/10.1111/jcpe.12588 CrossRefPubMed Thoma DS, Zeltner M, Hilbe M, Hammerle CH, Husler J, Jung RE (2016) Randomized controlled clinical study evaluating effectiveness and safety of a volume-stable collagen matrix compared to autogenous connective tissue grafts for soft tissue augmentation at implant sites. J Clin Periodontol 43:874–885. https://​doi.​org/​10.​1111/​jcpe.​12588 CrossRefPubMed
22.
Zurück zum Zitat Akcalı A, Trullenque-Eriksson A, Sun C, Petrie A, Nibali L and Donos N (2016) What is the effect of soft tissue thickness on crestal bone loss around dental implants? A systematic review. Clin Oral Implants Res Akcalı A, Trullenque-Eriksson A, Sun C, Petrie A, Nibali L and Donos N (2016) What is the effect of soft tissue thickness on crestal bone loss around dental implants? A systematic review. Clin Oral Implants Res
23.
Zurück zum Zitat Jung RE, Sailer I, Hammerle C, Attin T, Schmidlin P (2007) In vitro color changes of soft tissues caused by restorative materials. Int J Periodontics Restorative Dent 27:251PubMed Jung RE, Sailer I, Hammerle C, Attin T, Schmidlin P (2007) In vitro color changes of soft tissues caused by restorative materials. Int J Periodontics Restorative Dent 27:251PubMed
24.
Zurück zum Zitat Mir-Mari J, Benic GI, Valmaseda-Castellon E, Hammerle CH and Jung RE (2016) Influence of wound closure on the volume stability of particulate and non-particulate GBR materials: an in vitro cone-beam computed tomographic examination. Part II. Clin Oral Implants Res doi: https://doi.org/10.1111/clr.12845 Mir-Mari J, Benic GI, Valmaseda-Castellon E, Hammerle CH and Jung RE (2016) Influence of wound closure on the volume stability of particulate and non-particulate GBR materials: an in vitro cone-beam computed tomographic examination. Part II. Clin Oral Implants Res doi: https://​doi.​org/​10.​1111/​clr.​12845
26.
Zurück zum Zitat Harris RJ (2003) Histologic evaluation of connective tissue grafts in humans. Int J Periodontics Restorative Dent 23:575–583PubMed Harris RJ (2003) Histologic evaluation of connective tissue grafts in humans. Int J Periodontics Restorative Dent 23:575–583PubMed
27.
Zurück zum Zitat Studer SP, Lehner C, Bucher A, Scharer P (2000) Soft tissue correction of a single-tooth pontic space: a comparative quantitative volume assessment. J Prosthet Dent 83:402–411CrossRefPubMed Studer SP, Lehner C, Bucher A, Scharer P (2000) Soft tissue correction of a single-tooth pontic space: a comparative quantitative volume assessment. J Prosthet Dent 83:402–411CrossRefPubMed
29.
30.
Zurück zum Zitat Clementini M, Tiravia L, De Risi V, Vittorini Orgeas G, Mannocci A, de Sanctis M (2015) Dimensional changes after immediate implant placement with or without simultaneous regenerative procedures: a systematic review and meta-analysis. J Clin Periodontol 42:666–677. https://doi.org/10.1111/jcpe.12423 CrossRefPubMed Clementini M, Tiravia L, De Risi V, Vittorini Orgeas G, Mannocci A, de Sanctis M (2015) Dimensional changes after immediate implant placement with or without simultaneous regenerative procedures: a systematic review and meta-analysis. J Clin Periodontol 42:666–677. https://​doi.​org/​10.​1111/​jcpe.​12423 CrossRefPubMed
32.
Zurück zum Zitat Benic GI, Mokti M, Chen CJ, Weber HP, Hämmerle CH, Gallucci GO (2012) Dimensions of buccal bone and mucosa at immediately placed implants after 7 years: a clinical and cone beam computed tomography study. Clin Oral Implants Res 23:560–566CrossRefPubMed Benic GI, Mokti M, Chen CJ, Weber HP, Hämmerle CH, Gallucci GO (2012) Dimensions of buccal bone and mucosa at immediately placed implants after 7 years: a clinical and cone beam computed tomography study. Clin Oral Implants Res 23:560–566CrossRefPubMed
33.
Zurück zum Zitat Kuchler U, Chappuis V, Gruber R, Lang NP, Salvi GE (2016) Immediate implant placement with simultaneous guided bone regeneration in the esthetic zone: 10-year clinical and radiographic outcomes. Clin Oral Implants Res 27:253–257CrossRefPubMed Kuchler U, Chappuis V, Gruber R, Lang NP, Salvi GE (2016) Immediate implant placement with simultaneous guided bone regeneration in the esthetic zone: 10-year clinical and radiographic outcomes. Clin Oral Implants Res 27:253–257CrossRefPubMed
34.
Zurück zum Zitat Fickl S, Kebschull M, Schupbach P, Zuhr O, Schlagenhauf U, Hürzeler MB (2011) Bone loss after full-thickness and partial-thickness flap elevation. J Clin Periodontol 38:157–162CrossRefPubMed Fickl S, Kebschull M, Schupbach P, Zuhr O, Schlagenhauf U, Hürzeler MB (2011) Bone loss after full-thickness and partial-thickness flap elevation. J Clin Periodontol 38:157–162CrossRefPubMed
35.
Zurück zum Zitat Rubin CT, Lanyon LE (1985) Regulation of bone mass by mechanical strain magnitude. Calcif Tissue Int 37:411–417CrossRefPubMed Rubin CT, Lanyon LE (1985) Regulation of bone mass by mechanical strain magnitude. Calcif Tissue Int 37:411–417CrossRefPubMed
36.
Zurück zum Zitat Rubin CT, Lanyon L (1984) Regulation of bone formation by applied dynamic loads. J Bone Joint Surg Am 66:397–402CrossRefPubMed Rubin CT, Lanyon L (1984) Regulation of bone formation by applied dynamic loads. J Bone Joint Surg Am 66:397–402CrossRefPubMed
37.
Zurück zum Zitat Schmitt CM, Matta RE, Moest T, Humann J, Gammel L, Neukam FW, Schlegel KA (2016) Soft tissue volume alterations after connective tissue grafting at teeth: the subepithelial autologous connective tissue graft versus a porcine collagen matrix—a pre-clinical volumetric analysis. J Clin Periodontol 43:609–617. https://doi.org/10.1111/jcpe.12547 CrossRefPubMed Schmitt CM, Matta RE, Moest T, Humann J, Gammel L, Neukam FW, Schlegel KA (2016) Soft tissue volume alterations after connective tissue grafting at teeth: the subepithelial autologous connective tissue graft versus a porcine collagen matrix—a pre-clinical volumetric analysis. J Clin Periodontol 43:609–617. https://​doi.​org/​10.​1111/​jcpe.​12547 CrossRefPubMed
Metadaten
Titel
Volumetric and linear changes at dental implants following grafting with volume-stable three-dimensional collagen matrices or autogenous connective tissue grafts: 6-month data
verfasst von
Nadja Naenni
Stefan P. Bienz
Goran I. Benic
Ronald E. Jung
Christoph H. F. Hämmerle
Daniel S. Thoma
Publikationsdatum
18.09.2017
Verlag
Springer Berlin Heidelberg
Erschienen in
Clinical Oral Investigations / Ausgabe 3/2018
Print ISSN: 1432-6981
Elektronische ISSN: 1436-3771
DOI
https://doi.org/10.1007/s00784-017-2210-3

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