A multi-centre randomized controlled trial comparing connective tissue graft with collagen matrix to increase soft tissue thickness at the buccal aspect of single implants: 3-month results.
collagen matrix
connective tissue graft
dental implant
single tooth
Journal
Journal of clinical periodontology
ISSN: 1600-051X
Titre abrégé: J Clin Periodontol
Pays: United States
ID NLM: 0425123
Informations de publication
Date de publication:
12 2021
12 2021
Historique:
revised:
22
09
2021
received:
01
07
2021
accepted:
25
09
2021
pubmed:
5
10
2021
medline:
24
12
2021
entrez:
4
10
2021
Statut:
ppublish
Résumé
To compare connective tissue graft (CTG) with collagen matrix (CMX) in terms of changes over time in buccal soft tissue profile (BSP) when applied at single implant sites. Patients with a single tooth gap in the anterior maxilla and horizontal mucosa defect were enrolled in a multi-centre randomized controlled trial. All sites had a bucco-palatal bone dimension of at least 6 mm and received a single implant and immediate implant restoration using a full digital workflow. Sites were randomly allocated to the control (CTG) or test group (CMX: Geistlich Fibro-Gide®, Geistlich Pharma AG, Wolhusen, Switzerland) to increase buccal soft tissue thickness. Primary outcome was increase in BSP at T1 (immediately after operation) and T2 (3 months) based on superimposed digital surface models. Secondary parameters included patient-reported clinical and aesthetic outcomes. Thirty patients were included per group (control: 50% females, mean age 50; test: 53% females, mean age 48). Even though surgeons applied thicker grafts when using CMX, sites treated with CMX demonstrated 0.78 mm (95% CI 0.41-1.14) more shrinkage between T1 and T2 than sites treated with CTG. The final increase in BSP was 1.15 mm (95% CI 0.88-1.43) for CTG and 0.85 mm (95% CI 0.58-1.13) for CMX. The mean difference of 0.30 mm (95% CI -0.01 to 0.61) at T2 in favour of CTG was of borderline significance (p = .054). There were no significant differences between the groups in terms of post-operative bleeding (p = .344), pain (p = .331), number of analgesics taken (p = .504), oedema (p = .227), and pink aesthetic score (p = .655). VAS for post-operative haematoma was 6.56 (95% CI 0.54-12.59) lower for CMX, and surgery time could be reduced by 9.03 min (95% CI 7.04-11.03) when applying CMX. However, CMX resulted in significantly more marginal bone loss (0.38 mm; 95% CI 0.15-0.60), deeper pockets (0.30 mm; 95% CI 0.06-0.54), and more mid-facial recession (0.75 mm; 95% CI 0.39-1.12) than CTG. CTG remains the gold standard for increasing soft tissue thickness at the buccal aspect of implants.
Substances chimiques
Collagen
9007-34-5
Banques de données
ClinicalTrials.gov
['NCT04210596']
Types de publication
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1502-1515Informations de copyright
© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Références
Burkhardt, R., Hämmerle, C. H., & Lang, N. P. (2015). Self-reported pain perception of patients after mucosal graft harvesting in the palatal area. Journal of Clinical Periodontology, 42(3), 281-287. https://doi.org/10.1111/jcpe.12357
Buser, D., Martin, W., & Belser, U. C. (2004). Optimizing esthetics for implant restorations in the anterior maxilla: Anatomic and surgical considerations. The International Journal of Oral & Maxillofacial Implants, 19(Suppl), 43-61.
Cosyn, J., Wessels, R., Cabeza, R. G., Ackerman, J., Eeckhout, C., & Christiaens, V. (2021). Soft tissue metric parameters, methods and esthetic indices in implant dentistry: A critical review. Clinical Oral Implants Research (In press).
Couso-Queiruga, E., Stuhr, S., Tattan, M., Chambrone, L., & Avila-Ortiz, G. (2021). Post-extraction dimensional changes: A systematic review and meta-analysis. Journal of Clinical Periodontology, 48(1), 126-144. https://doi.org/10.1111/jcpe.13390
De Angelis, P., De Angelis, S., Passarelli, P. C., Liguori, M. G., Pompa, G., Papi, P., Manicone, P. F., & D'Addona, A. (2021). Clinical comparison of a xenogeneic collagen matrix versus subepithelial autogenous connective tissue graft for augmentation of soft tissue around implants. International Journal of Oral and Maxillofacial Surgery, 50(7), 956-963. https://doi.org/10.1016/j.ijom.2020.11.014
De Bruyckere, T., Cabeza, R. G., Eghbali, A., Younes, F., Cleymaet, R., & Cosyn, J. (2020). A randomized controlled study comparing guided bone regeneration with connective tissue graft to reestablish buccal convexity at implant sites: A 1-year volumetric analysis. Clinical Implant Dentistry and Related Research, 22(4), 468-476. https://doi.org/10.1111/cid.12934
De Bruyckere, T., Eghbali, A., Younes, F., De Bruyn, H., & Cosyn, J. (2015). Horizontal stability of connective tissue grafts at the buccal aspect of single implants: A 1-year prospective case series. Journal of Clinical Periodontology, 42(9), 876-882. https://doi.org/10.1111/jcpe.12448
Del Pizzo, M., Modica, F., Bethaz, N., Priotto, P., & Romagnoli, R. (2002). The connective tissue graft: A comparative clinical evaluation of wound healing at the palatal donor site. A preliminary study. Journal of Clinical Periodontology, 29(9), 848-854. https://doi.org/10.1034/j.1600-051x.2002.290910.x
Eeckhout, C., Bouckaert, E., Verleyen, D., De Bruyckere, T., & Cosyn, J. (2020). A 3-year prospective study on a porcine-derived acellular collagen matrix to re-establish convexity at the buccal aspect of single implants in the molar area: A volumetric analysis. Journal of Clinical Medicine, 9(5). https://doi.org/10.3390/jcm9051568
Eghbali, A., Seyssens, L., De Bruyckere, T., Younes, F., Cleymaet, R., & Cosyn, J. (2018). A 5-year prospective study on the clinical and aesthetic outcomes of alveolar ridge preservation and connective tissue graft at the buccal aspect of single implants. Journal of Clinical Periodontology, 45(12), 1475-1484. https://doi.org/10.1111/jcpe.13018
Furhauser, R., Florescu, D., Benesch, T., Haas, R., Mailath, G., & Watzek, G. (2005). Evaluation of soft tissue around single-tooth implant crowns: The pink esthetic score. Clinical Oral Implants Research, 16(6), 639-644. https://doi.org/10.1111/j.1600-0501.2005.01193.x
Griffin, T. J., Cheung, W. S., Zavras, A. I., & Damoulis, P. D. (2006). Postoperative complications following gingival augmentation procedures. Journal of Periodontology, 77(12), 2070-2079. https://doi.org/10.1902/jop.2006.050296
Huber, S., Zeltner, M., Hämmerle, C. H. F., Jung, R. E., & Thoma, D. S. (2018). Non-interventional 1-year follow-up study of peri-implant soft tissues following previous soft tissue augmentation and crown insertion in single-tooth gaps. Journal of Clinical Periodontology, 45(4), 504-512. https://doi.org/10.1111/jcpe.12865
Lambrechts, T., Doornewaard, R., De Bruyckere, T., Matthijs, L., Deschepper, E., & Cosyn, J. (2021). A multicenter cohort study on the association of the one-abutment one-time concept with marginal bone loss around bone level implants. Clinical Oral Implants Research, 32(2), 192-202. https://doi.org/10.1111/clr.13689
Naenni, N., Bienz, S. P., Benic, G. I., Jung, R. E., Hämmerle, C. H. F., & Thoma, D. S. (2018). Volumetric and linear changes at dental implants following grafting with volume-stable three-dimensional collagen matrices or autogenous connective tissue grafts: 6-month data. Clinical Oral Investigations, 22(3), 1185-1195. https://doi.org/10.1007/s00784-017-2210-3
O'Leary, T. J., Drake, R. B., & Naylor, J. E. (1972). The plaque control record. Journal of Periodontology, 43(1), 38. https://doi.org/10.1902/jop.1972.43.1.38
Rojo, E., Stroppa, G., Sanz-Martin, I., Gonzalez-Martín, O., Alemany, A. S., & Nart, J. (2018). Soft tissue volume gain around dental implants using autogenous subepithelial connective tissue grafts harvested from the lateral palate or tuberosity area. A randomized controlled clinical study. Journal of Clinical Periodontology, 45(4), 495-503. https://doi.org/10.1111/jcpe.12869
Rojo, E., Stroppa, G., Sanz-Martin, I., Gonzalez-Martín, O., & Nart, J. (2020). Soft tissue stability around dental implants after soft tissue grafting from the lateral palate or the tuberosity area-A randomized controlled clinical study. Journal of Clinical Periodontology, 47(7), 892-899. https://doi.org/10.1111/jcpe.13292
Rothamel, D., Benner, M., Fienitz, T., Happe, A., Kreppel, M., Nickenig, H. J., & Zöller, J. E. (2014). Biodegradation pattern and tissue integration of native and cross-linked porcine collagen soft tissue augmentation matrices-An experimental study in the rat. Head & Face Medicine, 10, 10. https://doi.org/10.1186/1746-160x-10-10
Sanz-Martín, I., Encalada, C., Sanz-Sánchez, I., Aracil, J., & Sanz, M. (2019). Soft tissue augmentation at immediate implants using a novel xenogeneic collagen matrix in conjunction with immediate provisional restorations: A prospective case series. Clinical Implant Dentistry and Related Research, 21(1), 145-153. https://doi.org/10.1111/cid.12696
Schmitt, C. M., Brückbauer, P., Schlegel, K. A., Buchbender, M., Adler, W., & Matta, R. E. (2021). Volumetric soft tissue alterations in the early healing phase after peri-implant soft tissue contour augmentation with a porcine collagen matrix versus the autologous connective tissue graft: A controlled clinical trial. Journal of Clinical Periodontology, 48(1), 145-162. https://doi.org/10.1111/jcpe.13387
Schulz, K. F., Altman, D. G., & Moher, D. (2010). CONSORT 2010 statement: Updated guidelines for reporting parallel group randomised trials. BMJ (Clinical Research Edition), 340, c332. https://doi.org/10.1136/bmj.c332
Seibert, J. S. (1983). Reconstruction of deformed, partially edentulous ridges, using full thickness onlay grafts. Part I. Technique and wound healing. Compendium of Continuing Education in Dentistry, 4(5), 437-453.
Smitkarn, P., Subbalekha, K., Mattheos, N., & Pimkhaokham, A. (2019). The accuracy of single-tooth implants placed using fully digital-guided surgery and freehand implant surgery. Journal of Clinical Periodontology, 46(9), 949-957. https://doi.org/10.1111/jcpe.13160
Tan, W. L., Wong, T. L., Wong, M. C., & Lang, N. P. (2012). A systematic review of post-extractional alveolar hard and soft tissue dimensional changes in humans. Clinical Oral Implants Research, 23(Suppl. 5), 1-21. https://doi.org/10.1111/j.1600-0501.2011.02375.x
Thoma, D. S., Buranawat, B., Hammerle, C. H., Held, U., & Jung, R. E. (2014). Efficacy of soft tissue augmentation around dental implants and in partially edentulous areas: A systematic review. Journal of Clinical Periodontology, 41(Suppl. 15), S77-S91. https://doi.org/10.1111/jcpe.12220
Thoma, D. S., Cosyn, J., Fickl, S., Jensen, S. S., Jung, R. E., Raghoebar, G. M., Rocchietta, I., Roccuzzo, M., Sanz, M., Sanz-Sánchez, I., Scarlat, P., Schou, S., Stefanini, M., Strasding, M., & Bertl, K. (2021). Consensus report of working group 2: Soft tissue management. Clinical Oral Implants Research. https://doi.org/10.1111/clr.13798
Thoma, D. S., Gasser, T. J. W., Jung, R. E., & Hämmerle, C. H. F. (2020). Randomized controlled clinical trial comparing implant sites augmented with a volume-stable collagen matrix or an autogenous connective tissue graft: 3-year data after insertion of reconstructions. Journal of Clinical Periodontology, 47(5), 630-639. https://doi.org/10.1111/jcpe.13271
Thoma, D. S., Naenni, N., Benic, G. I., Hämmerle, C. H., & Jung, R. E. (2017). Soft tissue volume augmentation at dental implant sites using a volume stable three-dimensional collagen matrix-Histological outcomes of a preclinical study. Journal of Clinical Periodontology, 44(2), 185-194. https://doi.org/10.1111/jcpe.12635
Thoma, D. S., Villar, C. C., Cochran, D. L., Hämmerle, C. H., & Jung, R. E. (2012). Tissue integration of collagen-based matrices: An experimental study in mice. Clinical Oral Implants Research, 23(12), 1333-1339. https://doi.org/10.1111/j.1600-0501.2011.02356.x
Thoma, D. S., Zeltner, M., Hilbe, M., Hämmerle, C. H., Hüsler, J., & Jung, R. E. (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. Journal of Clinical Periodontology, 43(10), 874-885. https://doi.org/10.1111/jcpe.12588
Wessels, R., De Roose, S., De Bruyckere, T., Eghbali, A., Jacquet, W., De Rouck, T., & Cosyn, J. (2019). The mucosal scarring index: Reliability of a new composite index for assessing scarring following oral surgery. Clinical Oral Investigations, 23(3), 1209-1215. https://doi.org/10.1007/s00784-018-2535-6
Younes, F., Cosyn, J., De Bruyckere, T., Cleymaet, R., Bouckaert, E., & Eghbali, A. (2018). A randomized controlled study on the accuracy of free-handed, pilot-drill guided and fully guided implant surgery in partially edentulous patients. Journal of Clinical Periodontology, 45(6), 721-732. https://doi.org/10.1111/jcpe.12897
Zeltner, M., Jung, R. E., Hämmerle, C. H., Hüsler, J., & Thoma, D. S. (2017). Randomized controlled clinical study comparing a volume-stable collagen matrix to autogenous connective tissue grafts for soft tissue augmentation at implant sites: Linear volumetric soft tissue changes up to 3 months. Journal of Clinical Periodontology, 44(4), 446-453. https://doi.org/10.1111/jcpe.12697
Zucchelli, G., Mounssif, I., Mazzotti, C., Montebugnoli, L., Sangiorgi, M., Mele, M., & Stefanini, M. (2014). Does the dimension of the graft influence patient morbidity and root coverage outcomes? A randomized controlled clinical trial. Journal of Clinical Periodontology, 41(7), 708-716. https://doi.org/10.1111/jcpe.12256