Clinical and histological wound healing patterns of collagen-based substitutes: An experimental randomized controlled trial in standardized palatal defects in humans.

AIM: To evaluate the progression of wound healing of standardized palatal defects in groups using three different collagen-based wound dressings and a control group, in terms of wound closure, pain perception and descriptive histology. MATERIALS AND METHODS: Twenty participants were enrolled in this experimental study, in whom four palatal defects were created. The defects (6 mm diameter, 3 mm depth) were randomly assigned to one of four treatment modalities: C (control), MG (Mucograft®), MD (mucoderm®) and FG (Fibro-Gide®). Photographs were taken, and pain assessment was performed before and after treatment and at 5, 7, 9, 12, 14 and 16 days after surgery. All participants wore a palatal splint for a duration of 16 days. RESULTS: All groups achieved complete wound closure at 14 days. The percentage of the remaining open wound on day 7 amounted to 49.3% (C; interquartile range [IQR]: 22.6), 70.1% (FG; IQR: 20.7), 56.8% (MD; IQR: 26.3) and 62.2% (MG; IQR: 34.4). Statistically significant differences were found between FG and C (p =.01) and between MD and FG (p =.04). None of the participants rated pain higher than 4 out of 10 during the entire study period. CONCLUSIONS: Collagen-based wound dressings provide coverage of open defects, albeit without acceleration of wound closure or reduction of pain. FG (which is not intended for open oral wounds) showed slower wound closure compared to C and MD.

Survival and complication rates of two dental implant systems supporting fixed restorations: 10-year data of a randomized controlled clinical study.

OBJECTIVES: To compare clinical, radiographic, biological and technical long-term outcomes of two types of dental implants over a period of 10 years. MATERIALS AND METHODS: Ninety-eight implants were placed in 64 patients, randomly allocated to one of two manufacturers (AST and STM). All implants were loaded with fixed restorations. Outcome measures were assessed at implant insertion (Ti), at baseline examination (TL), at 1, 3, 5, 8 and 10 (T10) years. Data analysis included survival, bone level changes, complications and clinical measures. RESULTS: Re-examination was performed in 43 patients (23 AST and 20 STM) at 10 years. The implant level analysis was based on 37 (AST) and 32 (STM) implants. Survival rates of 100% were obtained for both groups. The median changes of the marginal bone levels between baseline and T10 (the primary endpoint) amounted to a loss of 0.07 mm for group AST and a gain of 0.37 mm for group STM (intergroup p = 0.008). Technical complications occurred in 27.0% of the implants in group AST and in 15.6% in group STM. The prevalence of peri-implant mucositis was 29.7% (AST) and 50.1% (STM). The prevalence of peri-implantitis amounted to 0% (AST) and 6.3% (STM). CONCLUSIONS: Irrespective of the implant system used, the survival rates after 10 years were high. Minimal bone level changes were observed, statistically significant but clinically negligible in favor of STM. Technical complications were more frequently encountered in group AST, while group STM had a higher prevalence of peri-implant mucositis.

Gingipains impair attachment of epithelial cell to dental titanium abutment surfaces.

The study investigated in vitro the effect of Porphyromonas gingivalis and its cysteine proteases (gingipains) on epithelial cell adhesion to titanium-zirconium alloy surfaces. Titanium-zirconium discs with a standard machined (M) or chemically modified hydrophilic surface (modM) were coated with lamin-5 and incubated with telomerase-inactivated gingival keratinocytes (TIGK). Three P. gingivalis strains or gingipains were either added simultaneously with TIGK or after TIGK cells were already attached to the disks. Adhered TIGK cells were counted at 24 h. All P. gingivalis strains clearly inhibited adhesion of TIGK cells to M and modM surfaces. Compared with bacteria/gingipain-free TIGK cell cultures, the number of attached TIGK cells was reduced by about 80% and 60% when P. gingivalis was added simultaneously or after TIGK cells were already attached to the disks (each p < 0.01), respectively. Counts of attached cells were similarly reduced when only gingipains were used. Adhesion molecules of TIGK cells, in particular E-cadherin, were cleaved by P. gingivalis. In conclusion, P. gingivalis and gingipains interfere with the adhesion of epithelial cells to titanium-zirconium alloy surfaces by cleaving adhesion molecules, while a chemically modified hydrophilic titanium-zirconium alloy surface did not yield any protection. © 2019 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B:2549-2556, 2019.