IADR Abstract Archives
Increased Peri-Implant Keratinised Mucosa Width by Xenogenic Dermal Matrix (Mucoderm®). a Case Series
Objectives: An inadequate amount of peri-implant keratinised mucosa (PIKM) often imperils peri-implant health. If left untreated, peri-implant mucositis or peri-implantitis may occur. Therefore, sufficient width of keratinised mucosa around dental implants is considered one of the critical factors for the long-term success of dental implants. The gold standard of augmentation of PIKM is the use of autograft. However, the harvest of autogenous gingival grafts is associated with pain/discomfort and donor site morbidity. To overcome the inherent drawbacks of this surgical harvesting, alongside the limited volume, we aimed to evaluate a novel surgical technique with xenogenic dermal matrix (XDM) to increase PIKM.
Methods: Twelve patients with adequate peri-implant hard tissue but lack of PIKM-width (PIKM-W) were enrolled and signed an informed consent form. A split-thickness flap was gently prepared from the mucogingival junction towards the vestibule and sutured apically to the periosteum to create a non-moving periosteal bed. The XDM (mucoderm®; Botiss, Germany) was then rehydrated, precisely trimmed and positioned onto the periosteal site with its coronal edge tucked under the mucosa margin. Immobilisation of the XDM was then achieved with a deep periosteal anchoring sling and superficial monofilament mattress sutures. No gingival dressing was utilised, but chemical and professional mechanical plaque control instructions were given. The width of the PIKM was measured at baseline, 6 and 12 months later.
Results: All patients completed the study (4 females, 8 males; 55.9±14.4 years; non-smokers) with 21 implants (Straumann, Switzerland). Neither allergy, suppuration, rejection, ulceration, nor significant pain/discomfort were recorded. An adequate amount of PIKM, as well as a deep vestibule, was accomplished after one year. Mean PIKM-W gained statistical highly significance from 0.42±0.47 mm to 3.17± 1.21 mm at 6 months and 2.36±1.34mm at 12 months (p<0.001).
Conclusions: The investigated XDM may serve as a suitable substitute to autogenous soft tissue grafts for the establishment of ideal PIKM-width and deep vestibule. However, these positive results must be tested in well-designed randomised clinical trials to draw a firm clinical conclusion.
Methods: Twelve patients with adequate peri-implant hard tissue but lack of PIKM-width (PIKM-W) were enrolled and signed an informed consent form. A split-thickness flap was gently prepared from the mucogingival junction towards the vestibule and sutured apically to the periosteum to create a non-moving periosteal bed. The XDM (mucoderm®; Botiss, Germany) was then rehydrated, precisely trimmed and positioned onto the periosteal site with its coronal edge tucked under the mucosa margin. Immobilisation of the XDM was then achieved with a deep periosteal anchoring sling and superficial monofilament mattress sutures. No gingival dressing was utilised, but chemical and professional mechanical plaque control instructions were given. The width of the PIKM was measured at baseline, 6 and 12 months later.
Results: All patients completed the study (4 females, 8 males; 55.9±14.4 years; non-smokers) with 21 implants (Straumann, Switzerland). Neither allergy, suppuration, rejection, ulceration, nor significant pain/discomfort were recorded. An adequate amount of PIKM, as well as a deep vestibule, was accomplished after one year. Mean PIKM-W gained statistical highly significance from 0.42±0.47 mm to 3.17± 1.21 mm at 6 months and 2.36±1.34mm at 12 months (p<0.001).
Conclusions: The investigated XDM may serve as a suitable substitute to autogenous soft tissue grafts for the establishment of ideal PIKM-width and deep vestibule. However, these positive results must be tested in well-designed randomised clinical trials to draw a firm clinical conclusion.