Moscow, Moscow, Russian Federation
graduate student
Moscow, Moscow, Russian Federation
student
Moscow, Moscow, Russian Federation
student
Moskva, Moscow, Russian Federation
employee from 01.01.2013 until now
Moscow, Moscow, Russian Federation
UDK 616.31 Стоматология. Заболевания ротовой полости и зубов
The aim is to comparatively analyze the using of collagen matrix and free connective tissue graft in soft tissue thickness increase in the area of dental implants in the anterior region of the upper jaw. Materials and methods. 30 patients with partial absence of teeth and soft tissue thickness deficit in the anterior part of the upper jaw took part in the study. In the 1st group (n = 15) a free connective tissue graft (CTG) from the hard palate was transplanted, in the 2nd group (n = 15) a collagen matrix (CM) was used. The primary endpoint was the amount of soft tissue thickness gain 3 months after surgery. Secondary endpoints were: duration of surgery, severity of collateral edema and pain, amount of analgesic medication consumed, quality of life assessment, width of keratinized attached gingiva, and soft tissue aesthetics. Results. 3 months after augmentation the increase in soft tissue thickness from the vestibular surface was 0.86 ± 0.25 mm and 0.77 ± 0.26 mm (p = 0.34), from the occlusal surface - 0.46 ± 0.14 mm and 0.37 ± 0.18 mm (p = 0.137) in patients of the 1st and 2nd groups, respectively. The use of CM was characterized by less prolonged surgery (p = 0.002), less pronounced postoperative pain on the 1st and 3rd day (p = 0.007; p = 0.023), less consumption of analgesic drugs on the 1st, 3rd and 5th day (p = 0.014; p = 0.033; p = 0.002) and less reduction of patients' quality of life in the first 7 days after surgery (p = 0.023). When analyzing the "Pink Esthetics Scale" (PES) in patients, group 2 showed more pronounced inconsistencies in the assessment of the zenith level (p < 0.001), less natural soft tissue contour (p < 0.001) and more significant deficit of the alveolar ridge (p < 0.001). Conclusion. Collagen matrixes make it possible to obtain soft tissue augmentation comparable with the use of CTG, to reduce the time of surgical intervention and to provide a more comfortable postoperative period. The use of autogenous grafts provides better results in terms of soft tissue aesthetics.
xenogeneic collagen matrix, free connective tissue graft, dental implant, soft tissue augmentation, gingival surgery
1. De Angelis P., De Angelis S., Passarelli P.C., Liguori M.G., Pompa G., Papi P., Manicone P.F., D’Addona A. 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;50:956-963. doi:https://doi.org/10.1016/j.ijom.2020.11.014
2. De Annuntiis C., Testarelli L., Guarnieri R. Use of Xenogenic Collagen Matrices in Peri-Implant Soft Tissue Volume Augmentation: A Critical Review on the Current Evidence and New Technique Presentation // Materials. - 2022;15:3937. doi:https://doi.org/10.3390/ma15113937
3. Ashurko I.P., Magdalyanova M.L., Galyas A.I., Balyasin M.V., Skulbeda D.V., Krylova D.A., Tarasenko S.V. Comparative analysis of various soft tissue augmentation technique effectiveness around implants // Parodontologiya. - 2023;28:286-295. doi:https://doi.org/10.33925/1683-3759-2023-783
4. Ashurko I.P., Tarasenko S.V., Esayan A.V., Galyas A.I. 3D volumetric analysis at implant sites after soft tissue augmentation // Medical alphabet. - 2022:79-85. doi:https://doi.org/10.33667/2078-5631-2022-7-79-84
5. Ashurko I.P., Tarasenko S.V., Esayan A.V., Galyas A.I., Kustova J.I. Comparative histomorphometric analysis of peri-implant soft tissue formed after the augmentation with connective tissue graft and collagen matrix // Rossiiskaya stomatologiya. - 2022;15:22. doi:https://doi.org/10.17116/rosstomat20221502122
6. Caballé-Serrano J., Zhang S., Sculean A., Staehli A., Bosshardt D.D. Tissue Integration and Degradation of a Porous Collagen-Based Scaffold Used for Soft Tissue Augmentation // Materials. - 2020;13:2420. doi:https://doi.org/10.3390/ma13102420
7. Cairo F., Barbato L., Tonelli P., Batalocco G., Pagavino G., Nieri M. Xenogeneic collagen matrix versus connective tissue graft for buccal soft tissue augmentation at implant site. A randomized, controlled clinical trial // J Clin Periodontol. - 2017;44:769-776. doi:https://doi.org/10.1111/jcpe.12750
8. Chappuis V., Araújo M.G., Buser D. Clinical relevance of dimensional bone and soft tissue alterations post-extraction in esthetic sites // Periodontol 2000. - 2017;73:73-83. doi:https://doi.org/10.1111/prd.12167
9. Cosyn J., Eeckhout C., Christiaens V., Eghbali A., Vervaeke S., Younes F., De Bruyckere T. 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 // J Clin Periodontol. - 2021;48:1502-1515. doi:https://doi.org/10.1111/jcpe.13560
10. 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;34:1059-1069. doi:https://doi.org/10.11607/jomi.7497
11. Gonzalez-Martin O., Avila-Ortiz G., Gonzalez-Martin O., Couso-Queiruga E., Wang H.L. The peri-implant phenotype // Journal of Periodontology. - 2020;91(3):283-288. doi:https://doi.org/10.1002/JPER.19-0566
12. Guo T., Gulati K., Arora H., Han P., Fournier B., Ivanovski S., Guo T., Gulati K., Arora H., Han P., Fournier B., Ivanovski S. Orchestrating soft tissue integration at the transmucosal region of titanium implants // Acta Biomater. - 2021:33-49. doi:https://doi.org/10.1016/j.actbio.2021.01.001
13. 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;12:924. doi:https://doi.org/10.3390/jcm12030924
14. Harris R.J. The Connective Tissue and Partial Thickness Double Pedicle Graft: A Predictable Method of Obtaining Root Coverage // J Periodontol. - 1992;63:477-486. doi:https://doi.org/10.1902/jop.1992.63.5.477
15. Hosseini M., Worsaae N., Gotfredsen K. Tissue changes at implant sites in the anterior maxilla with and without con- nective tissue grafting: a five-year prospective study // Clin Oral Implants Res. - 2020:18-28. doi:https://doi.org/10.1111/clr.13540
16. Huber S., Zeltner M., Hämmerle C.H.F., Jung R.E., Thoma D.S. Non-interventional 1-year follow-up study of peri-implant soft tissues following previous soft tissue augmentation and crown insertion in single-tooth gaps // J Clin Periodontol. - 2018;45:504-512. doi:https://doi.org/10.1111/jcpe.12865
17. Jung R.E., Becker K., Bienz S.P., Dahlin C., Donos N., Hammächer C., Iglhaut G., Liñares A., Ortiz-Vigón A., Sanchez N., Sanz-Sánchez I., Thoma D.S., Valles C., Weng D., Nart J. Effect of peri-implant mucosal thickness on esthetic outcomes and the efficacy of soft tissue augmentation procedures: Consensus report of group 2 of the SEPA/DGI/OF workshop // Clin Oral Implants Res. - 2022;33:100-108. doi:https://doi.org/10.1111/clr.13955
18. Lorenzo R., García V., Orsini M., Martin C., Sanz M. Clinical efficacy of a xenogeneic collagen matrix in augmenting keratinized mucosa around implants: A randomized controlled prospective clinical trial // Clin Oral Implants Res. - 2012;23:316-324. doi:https://doi.org/10.1111/j.1600-0501.2011.02260.x
19. Pandey C., Rokaya D., Bhattarai B.P. Contemporary Concepts in Osseointegration of Dental Implants: A Review // Biomed Res Int. - 2022:1-11. doi:https://doi.org/10.1155/2022/6170452
20. Puisys A., Deikuviene J., Vindasiute-Narbute E., Razukevicus D., Zvirblis T., Linkevicius T. Connective tissue graft vs porcine collagen matrix after immediate implant placement in esthetic area: A randomized clinical trial // Clin Implant Dent Relat Res. - 2022;24:141-150. doi:https://doi.org/10.1111/cid.13058
21. Sanz M., Lorenzo R., Aranda J.J., Martin C., Orsini M. Clinical evaluation of a new collagen matrix (Mucograft® prototype) to enhance the width of keratinized tissue in patients with fixed prosthetic restorations: A randomized prospective clinical trial // J Clin Periodontol. - 2009;36:868-876. doi:https://doi.org/10.1111/j.1600-051X.2009.01460.x
22. Schmitt C.M., Brückbauer P., Schlegel K.A., Buchbender M., Adler W., Matta R.E. 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 // J Clin Periodontol. - 2021;48:145-162. doi:https://doi.org/10.1111/jcpe.13387
23. Tarasenko S.V., Zagorskij S.V. Review of methodology and materials using for building of gum soft tissues // Journal of Clinical Practice. - 2019;10:57-62. doi:https://doi.org/10.17816/clinpract10157-62
24. Thoma D.S., Naenni N., Benic G.I., Hämmerle C.H.F., Jung R.E. Soft tissue volume augmentation at dental implant sites using a volume stable three-dimensional collagen matrix - histological outcomes of a preclinical study // J Clin Periodontol. - 2017;44:185-194. doi:https://doi.org/10.1111/jcpe.12635
25. Thoma D.S., Zeltner M., Hilbe M., Hämmerle C.H.F., Hüsler J., Jung R.E. 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. - 2016;43:874-885. doi:https://doi.org/10.1111/jcpe.12588
26. Vatėnas I., Linkevičius T. The use of the connective tissue graft from the palate for vertical soft tissue augmentation during submerged dental implant placement: A case series // Clin Exp Dent Res. - 2022;8:1103-1108. doi:https://doi.org/10.1002/cre2.626
27. Zucchelli G., Tavelli L., McGuire M.K., Rasperini G., Feinberg S.E., Wang H.L., Giannobile W.V. Autogenous soft tissue grafting for periodontal and peri-implant plastic surgical reconstruction // J Periodontol. - 2020;91:9-16. doi:https://doi.org/10.1002/JPER.19-0350.
28. Ashurko I.P., Galyas A.I., Skul'beda D.V. Primenenie kollagenovogo matriksa dlya augmentacii myagkih tkaney v oblasti dental'nyh implantatov. Federal'noe gosudarstvennoe byudzhetnoe obrazovatel'noe uchrezhdenie vysshego obrazovaniya “Kirovskiy gosudarstvennyy medicinskiy universitet” Ministerstva zdravoohraneniya Rossiyskoy Federacii. 2023. [I.P. Ashurko, A.I. Galyas, D.V. Skulbeda. Application of collagen matrix for soft tissue augmentation in the area of dental implants. Federal State Budgetary Educational Institution of Higher Education “Kirov State Medical University” of the Ministry of Health of the Russian Federation. 2023. (In Russ.)]. https://elibrary.ru/item.asp?id=53793532
29. Ashurko I.P., Krylova D.A., Shehter A.B., Davletshin D.N., Tarasenko S.V. Primenenie kollagenovogo matriksa dlya augmentacii myagkih tkaney vo frontal'nom otdele verhney chelyusti. Aktual'nye problemy mediciny. 2023;46:261-273. [I.P. Ashurko, D.A. Krylova, A.B. Shekhter, D.N. Davletshin, S.V. Tarasenko. Application of collagen matrix for soft tissue augmentation in the anterior maxilla. Current problems of medicine. 2023;46:261-273. (In Russ.)]. https://cyberleninka.ru/article/n/primenenie-kollagenovogo-matriksa-dlya-augmentatsii-myagkih-tkaney-vo-frontalnom-otdele-verhney-chelyusti
30. Ashurko I.P., Savel'eva D.A., Galyas A.I., Tarasenko S.V. Ispol'zovanie kollagenovogo matriksa dlya uvelicheniya tolschiny myagkih tkaney v oblasti dental'nyh implantatov. Federal'noe gosudarstvennoe byudzhetnoe obrazovatel'noe uchrezhdenie vysshego obrazovaniya “Kirovskiy gosudarstvennyy medicinskiy universitet” Ministerstva zdravoohraneniya Rossiyskoy Federacii. 2022. [I.P. Ashurko, D.A. Savelyeva, A.I. Galyas, S.V. Tarasenko. Using a collagen matrix to increase the thickness of soft tissue in the area of dental implants. Federal State Budgetary Educational Institution of Higher Education “Kirov State Medical University” of the Ministry of Health of the Russian Federation. 2022. (In Russ.)]. https://elibrary.ru/item.asp?id=48823683
31. Ashurko I.P., Tarasenko S.V., Esayan A.V., Galyas A.I., Li A.V. Ocenka klinicheskoy effektivnosti primeneniya svobodnogo soedinitel'notkannogo transplantata i kollagenovogo matriksa dlya uvelicheniya tolschiny myagkih tkaney v oblasti dental'nyh implantatov. Parodontologiya. 2022;27:117-125. [I.P. Ashurko, S.V. Tarasenko, A.V. Yesayan, A.I. Galyas, A.V. Lee. Evaluation of the clinical effectiveness of using a free connective tissue graft and collagen matrix to increase the thickness of soft tissue in the area of dental implants. Periodontology. 2022;27:117-125. (In Russ.)]. doi:https://doi.org/10.33925/1683-3759-2022-27-2-117-125
