Profilometric analysis of cross-linked collagen matrix for soft tissue thickness augmentation in dental implants: A randomized controlled clinical trial

Abstract

BACKGROUND: Dental implantation is an effective method for rehabilitating patients without teeth. The long-term survival of implants is influenced by various factors, one of which is the condition of the soft tissue surrounding the implant.

AIM: To evaluate the effectiveness of cross-linked collagen matrix for soft tissue augmentation in the implant area.

MATERIALS AND METHODS: Thirty-two patients with soft tissue thickness deficiency were examined. The patients were divided into two groups depending on the method of surgery. Group 1 received a cross-linked collagen matrix, whereas group 2 underwent the transplantation of a free connective tissue graft. The increase in soft tissue thickness was assessed 3 and 6 months after surgery.

RESULTS: Soft tissue thickness 3 months after surgery increased by 1.77±0.61 and 1.26±0.41 mm in groups 1 and 2, respectively (p <0.001). Moreover, 6 months after surgery, soft tissue thickness increased by 1.11±0.44 and 1.43±0.81 mm compared with the initial value (p=0.012).

CONCLUSION: The use of the collagen matrix increases the soft tissue thickness in the implant area; however, the effect size is lower than that obtained by autograft transplantation.

Keywords

soft tissue thickness increase / gingival plasty / gingival augmentation / collagen matrix / peri-implant tissues / dental implantation

References

[1] World Health Organization [Internet]. Oral health. Available from: https://www.who.int/news-room/fact-sheets/detail/oral-health

[2] World Health Organization [Internet]. Oral health. Доступ по ссылке: https://www.who.int/news-room/fact-sheets/detail/oral-health

[3] Thoma DS, Gasser TJW, Hämmerle CHF, Strauss FJ, Jung RE. Soft tissue augmentation with a volume-stable collagen matrix or an autogenous connective tissue graft at implant sites: Five-year results of a randomized controlled trial post implant loading. J Periodontol. 2023;94(2):230–243. doi: 10.1002/JPER.22-0226

[4] Thoma D.S., Gasser T.J., Hämmerle C.H., Strauss F.J., Jung R.E. Soft tissue augmentation with a volume-stable collagen matrix or an autogenous connective tissue graft at implant sites: Five-year results of a randomized controlled trial post implant loading // J Periodontol. 2023. Vol. 94, N 2. P. 230–243. doi: 10.1002/JPER.22-0226

[5] Monje A, Kan JY, Borgnakke W. Impact of local predisposing/precipitating factors and systemic drivers on peri-implant diseases. Clin Implant Dent Relat Res. Published online 2022 Dec 19. doi: 10.1111/cid.13155

[6] Monje A., Kan J.Y., Borgnakke W. Impact of local predisposing/precipitating factors and systemic drivers on peri-implant diseases // Clin Implant Dent Relat Res. Published online 2022 Dec 19. doi: 10.1111/cid.13155

[7] Puzio M, Hadzik J, Błaszczyszyn A, Gedrange T, Dominiak M. Soft tissue augmentation around dental implants with connective tissue graft (CTG) and xenogenic collagen matrix (XCM). 1-year randomized control trail. Ann Anat. 2020;230:151484. doi: 10.1016/j.aanat.2020.151484

[8] Puzio M., Hadzik J., Błaszczyszyn A., Gedrange T., Dominiak M. Soft tissue augmentation around dental implants with connective tissue graft (CTG) and xenogenic collagen matrix (XCM). 1-year randomized control trail // Ann Anat. 2020. Vol. 230. 151484. doi: 10.1016/j.aanat.2020.151484

[9] Kulakov AA, Badalyan VA, Parinov DA, Martirosova AYu. Modern approaches to increase the volume of soft tissues in the area of teeth and implants using connective tissue grafts. Mezhdunarodnyi zhurnal prikladnykh i fundamental’nykh issledovanii. 2020;(2):69–73. (In Russ). doi: 10.17513/mjpfi.13012

[10] Кулаков А.А., Бадалян В.А., Паринов Д.А., Мартиросова А.Ю. Cовременные подходы увеличения объёма мягких тканей в области зубов и имплантатов с использованием соединительнотканных аутотрансплантатов // Международный журнал прикладных и фундаментальных исследований. 2020. № 2. С. 69–73. doi: 10.17513/mjpfi.13012

[11] Thoma DS, Gil A, Hämmerle CHF, Jung RE. Management and prevention of soft tissue complications in implant dentistry. Periodontol 2000. 2022;88(1):116–129. doi: 10.1111/prd.12415

[12] Thoma D.S., Gil A., Hämmerle C.H.F., Jung R.E. Management and prevention of soft tissue complications in implant dentistry // Periodontol 2000. 2022. Vol. 88, N 1. P. 116–129. doi: 10.1111/prd.12415

[13] Thoma DS, Naenni N, Figuero E, et al. Effects of soft tissue augmentation procedures on peri-implant health or disease: A systematic review and meta-analysis. Clin Oral Implants Res. 2018;29 Suppl. 15:32–49. doi: 10.1111/clr.13114

[14] Thoma D.S., Naenni N., Figuero E., et al. Effects of soft tissue augmentation procedures on peri-implant health or disease: A systematic review and meta-analysis // Clin Oral Implants Res. 2018. Vol. 29 Suppl. 15. P. 32–49. doi: 10.1111/clr.13114

[15] Ashurko I, Tarasenko S, Esayan A, et al. Connective tissue graft versus xenogeneic collagen matrix for soft tissue augmentation at implant sites: a randomized-controlled clinical trial. Clin Oral Investig. 2022;26(12):7191–7208. doi: 10.1007/s00784-022-04680-x

[16] Ashurko I., Tarasenko S., Esayan A., et al. Connective tissue graft versus xenogeneic collagen matrix for soft tissue augmentation at implant sites: a randomized-controlled clinical trial // Clin Oral Investig. 2022. Vol. 26, N 12. P. 7191–7208. doi: 10.1007/s00784-022-04680-x

[17] Melezhechkina IA, Atrushkevich VG, Berchenko GN. Comparative morphological assessment of crosslinked and non-crosslinked xenograft biointegration quality. Parodontologiya. 2022;27(4):288–297. doi: 10.33925/1683-3759-2022-27-4-288-297

[18] Мележечкина И.А., Атрушкевич В.Г., Берченко Г.Н. Сравнительная морфологическая оценка качества биоинтеграции сшитых и несшитых ксеногенных материалов // Пародонтология. 2022. Т. 27, № 4. С. 288–297. doi: 10.33925/1683-3759-2022-27-4-288-297

[19] Vallecillo C, Toledano-Osorio M, Vallecillo-Rivas M, et al. Collagen matrix vs. autogenous connective tissue graft for soft tissue augmentation: A systematic review and meta-analysis. Polymers. 2021;13(11):1810. doi: 10.3390/polym13111810

[20] Vallecillo C., Toledano-Osorio M., Vallecillo-Rivas M., et al. Collagen matrix vs. autogenous connective tissue graft for soft tissue augmentation: A systematic review and meta-analysis // Polymers. 2021. Vol. 13, N 11. 1810. doi: 10.3390/polym13111810

[21] Gargallo-Albiol J, Barootchi S, Tavelli L, Wang HL. Efficacy of xenogeneic collagen matrix to augment peri-implant soft tissue thickness compared to autogenous connective tissue graft: A systematic review and meta-analysis. Int J Oral Maxillofac Implants. 2019;34(5):1059–1069. doi: 10.11607/jomi.7497

[22] Gargallo-Albiol J., Barootchi S., Tavelli L., Wang H.L. Efficacy of xenogeneic collagen matrix to augment peri-implant soft tissue thickness compared with autogenous connective tissue graft: A systematic review and meta-analysis // Int J Oral Maxillofac Implants. 2019. Vol. 34, N 5. P. 1059–1069. doi: 10.11607/jomi.7497

[23] Lin GH, Madi IM. Soft-tissue conditions around dental implants: A literature review. Implant Dent. 2019;28(2):138–143. doi: 10.1097/ID.0000000000000871

[24] Lin G.H., Madi I.M. Soft-tissue conditions around dental implants: A literature review // Implant Dent. 2019. Vol. 28, N 2. P. 138–143. doi: 10.1097/ID.0000000000000871

[25] Cairo F, Barbato L, Tonelli P, et al. Xenogeneic collagen matrix versus connective tissue graft for buccal soft tissue augmentation at implant site. A randomized, controlled clinical trial. J Clin Periodontol. 2017;44(7):769–776. doi: 10.1111/jcpe.12750

[26] Cairo F., Barbato L., Tonelli P., et al. Xenogeneic collagen matrix versus connective tissue graft for buccal soft tissue augmentation at implant site. A randomized, controlled clinical trial // J Clin Periodontol. 2017. Vol. 44, N 7. P. 769–776. doi: 10.1111/jcpe.12750

[27] De Angelis P, De Angelis S, Passarelli PC, et al. Clinical comparison of a xenogeneic collagen matrix versus subepithelial autogenous connective tissue graft for augmentation of soft tissue around implants. Int J Oral Maxillofac Surg. 2021;50(7):956–963. doi: 10.1016/j.ijom.2020.11.014

[28] De Angelis P., De Angelis S., Passarelli P.C., et al. Clinical comparison of a xenogeneic collagen matrix versus subepithelial autogenous connective tissue graft for augmentation of soft tissue around implants // Int J Oral Maxillofac Surg. 2021. Vol. 50, N 7. P. 956–963. doi: 10.1016/j.ijom.2020.11.014

[29] Ashurko IP, Tarasenko SV, Esayan AV, Galyas AI, Li AV. Evaluation of free connective tissue graft and collagen matrix clinical effectiveness to increase soft tissue thickness around dental implants. Parodontologiya. 2022;27(2):117–125. doi: 10.33925/1683-3759-2022-27-2-117-125

[30] Ашурко И.П., Тарасенко С.В., Есаян А.В., Галяс А.И., Ли А.В. Оценка клинической эффективности применения свободного соединительнотканного трансплантата и коллагенового матрикса для увеличения толщины мягких тканей в области дентальных имплантатов // Пародонтология. 2022. Т. 27, № 2. С. 117–125. doi: 10.33925/1683-3759-2022-27-2-117-125

[31] Sanz-Martín I, Rojo E, Maldonado E, et al. Structural and histological differences between connective tissue grafts harvested from the lateral palatal mucosa or from the tuberosity area. Clin Oral Investig. 2019;23(2):957–964. doi: 10.1007/s00784-018-2516-9

[32] Sanz-Martín I., Rojo E., Maldonado E., et al. Structural and histological differences between connective tissue grafts harvested from the lateral palatal mucosa or from the tuberosity area // Clin Oral Investig. 2019. Vol. 23, N 2. P. 957–964. doi: 10.1007/s00784-018-2516-9

[33] Thoma DS, Strauss FJ, Mancini L, Gasser TJW, Jung RE. Minimal invasiveness in soft tissue augmentation at dental implants: A systematic review and meta-analysis of patient-reported outcome measures. Periodontol 2000. 2023;91(1):182–198. doi: 10.1111/prd.12465

[34] Thoma D.S., Strauss F.J., Mancini L., Gasser T.J.W., Jung R.E. Minimal invasiveness in soft tissue augmentation at dental implants: A systematic review and meta-analysis of patient-reported outcome measures // Periodontol 2000. 2023. Vol. 91, N 1. P. 182–198. doi: 10.1111/prd.12465

[35] Hadzik J, Błaszczyszyn A, Gedrange T, Dominiak M. Soft-tissue augmentation around dental implants with a connective tissue graft (CTG) and xenogeneic collagen matrix (CMX)—5-year follow-up. J Clin Med. 2023;12(3):924. doi: 10.3390/jcm12030924

[36] Hadzik J., Błaszczyszyn A., Gedrange T., Dominiak M. Soft-tissue augmentation around dental implants with a connective tissue graft (CTG) and xenogeneic collagen matrix (CMX)—5-year follow-up // J Clin Med. 2023. Vol. 12, N 3. 924. doi: 10.3390/jcm12030924

[37] Sarkisyan VM, Zayratyants OV, Panin AM, Panin MG. Morphological singularities of the various gingival biotypes. Parodontologiya. 2012;17(1):26–29.

[38] Саркисян В.М., Зайратьянц О.В., Панин А.М., Панин М.Г. Морфологические особенности десны разных биотипов // Пародонтология. 2012. T. 17, № 1. С. 26–29.

[39] Eghbali A, De Bruyn H, Cosyn J, Kerckaert I, Van Hoof T. Ultrasonic assessment of mucosal thickness around implants: validity, reproducibility, and stability of connective tissue grafts at the buccal aspect. Clin Implant Dent Relat Res. 2016;18(1):51–61. doi: 10.1111/cid.12245

[40] Eghbali A., De Bruyn H., Cosyn J., Kerckaert I., Van Hoof T. Ultrasonic assessment of mucosal thickness around implants: validity, reproducibility, and stability of connective tissue grafts at the buccal aspect // Clin Implant Dent Relat Res. 2016. Vol. 18, N 1. P. 51–61. doi: 10.1111/cid.12245

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