Yekaterinburg, Ekaterinburg, Russian Federation
Ufa, Russian Federation
Ufa, Ufa, Russian Federation
Ekaterinburg, Ekaterinburg, Russian Federation
UDC 616.31
Relevance. Thin gingival biotype is a significant risk factor for the development of recession, mucositis and periimplantitis, which determines the need for its correction at the stage of dental implantation. Autoplasty remains the “gold standard”, however, its application is associated with additional trauma of the donor area. In this regard, the use of allogeneic materials is a promising direction. Objective: To compare the clinical and morphological effectiveness of various types of allogeneic grafts from the Alloplant series for increasing gingival thickness in patients with a thin biotype their biotype. Materials and methods. A randomized controlled study was conducted with the participation of 160 patients divided into 8 groups. Soft tissue augmentation using allografts of types I (pericardium), II (broad fascia of the thigh), III (dura mater), and IV (testicular tunica albuginea) was performed simultaneously with the implant installation in patients of the main group (n = 80). The comparison groups included patients with autoplasty (palate, maxillary tubercle, n = 40), xenoplasty (Bio-Gide®, n = 20), and a control group without augmentation (n = 20). The gingival thickness assessment and morphological examination of biopsies were performed after 6 months. Results. The greatest increase in gingival thickness was observed 6 months later in the groups using type I, II, and III allografts (up to 2.34 ±0.09 mm, 2.16 ±0.08 mm, and 2.10 ±0.08 mm, respectively), which significantly exceeded the results in the autograft (~1.6 mm), xenograft (1.72 ±0.81 mm), and control groups (1.57 ±0.61 mm). The lowest efficiency was observed in type IV allografts (1.81 ±0.74 mm). Morphologically, when using type I–III allografts, a mature, well-vascularized connective tissue regenerate was formed without signs of inflammation, corresponding to the "thick" phenotype. When using type IV allografts and in the control group, a "thin" phenotype was formed. Conclusion. Alloplant allografts based on pericardium, broad fascia of the thigh and dura mater are a highly effective alternative to autogenous grafts for increasing the biotype of the gingiva, providing predictable formation of a “thick” phenotype, stability of results and minimal invasiveness.
dental implantation, thin biotype of the gingiva, soft-tissue augmentation, allograft, Alloplant, thickness of the gingiva, morphology
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