ABSTRACT
Background Soft tissue augmentation is a critical procedure in dental implantology aimed at improving peri-implant health and aesthetics. Various materials are used for this purpose, but their comparative effectiveness remains under-researched. This study aimed to evaluate the effects of soft tissue augmentation utilizing two different materials after tooth extraction on peri-implant clinical and radiographic outcomes. Methodology A randomized controlled trial was conducted with 30 participants requiring extraction of non-restorable mandibular posterior teeth. Participants were randomly assigned to receive connective tissue graft (CTG), Fibro-gide (FG), or spontaneous healing (SH) in a 1:1:1 allocation ratio. Two months post-treatment, dental implants were placed. Six months after the functional loading of the dental implant, peri-implant health was assessed using the Plaque Accumulation Index, bleeding on probing (BOP), pocket depth, mucosal recession, and marginal bone level. Results At the six-month follow-up, the SH group exhibited significantly higher Plaque Index and BOP percentages (6.43 ± 1.23 and 70%, respectively) compared to the CTG group (0.40 ± 0.32 and 8.3%, respectively) and FG group (0.45 ± 0.44 and 9.7%, respectively). The mean probing pocket depth was also significantly higher in the control group (5.13 ± 0.64 mm), while the CTG and FG groups showed minimal changes (3.83 ± 0.39 mm for both groups). Additionally, gingival recession was higher in the control group (0.65 ± 0.18 mm) compared to the CTG and FG groups (0.03 ± 0.08 mm for both groups). Radiographic analysis revealed greater marginal bone loss in the control group (0.40 ± 0.05 mm) compared to the CTG and FG groups, which demonstrated minimal bone loss (0.17 ± 0.08 mm and 0.20 ± 0.00 mm, respectively). Conclusions The study findings indicate that FG is as effective as CTG in maintaining peri-implant health, outperforming SH. These findings suggest that FG can be a viable alternative to CTG in soft tissue augmentation after tooth extraction, offering a new option for clinicians in the management of extraction sites before dental implant placement.
ABSTRACT
AIMS: High-risk human papillomaviruses (HPVs) constitute an important risk factor for tonsillar cancer. This study describes changes in cell adhesion molecules during metastasis of HPV-related and HPV-unrelated tonsillar carcinomas. METHODS AND RESULTS: We examined 48 primary tonsillar carcinoma samples (25 HPV-16 DNA-positive, 23 HPV-16 DNA-negative) and their respective lymph node metastases for their HPV status and for the expression of p16, epithelial cadherin (E-cadherin), ß-catenin, and vimentin. A positive HPV-specific polymerase chain reaction finding correlated significantly with p16 overexpression in both primary tumours and their metastases (P<0.0001 for both). In HPV-unrelated carcinomas, the expression of E-cadherin was significantly lower in metastases than in primary tumours (P<0.001). In contrast, the expression of nuclear ß-catenin was significantly higher in metastases than in primary tumours (P=0.016). In HPV-related carcinomas, nuclear localization of ß-catenin expression was already apparent in primary tumours (P=0.030). The expression of vimentin significantly correlated with the grading of the primary tumour (P=0.021). CONCLUSIONS: Our data indicate that the down-regulation of E-cadherin and the up-regulation of nuclear ß-catenin expression might be crucial steps during tumour progression of tonsillar carcinomas, being already present in primary tumours in HPV-driven carcinomas, but becoming apparent in HPV-unrelated tumours later in the process of metastasis.