Root Coverage Using a Novel Porcine Acellular Dermal Matrix: Case Reports of Different Minimally Invasive Techniques with a 3-Year Follow-up.

A recently released commercially available novel porcine acellular dermal matrix (PADM) appears to possess acceptable biologic and clinical properties to be considered as an acceptable soft tissue replacement material. The aim of these three case reports is to present the treatment of multiple gingival recession by means of different variations of the tunnel and PADM as well as the clinical outcomes obtained at 3 years postoperatively. The healing outcomes demonstrated only minor surgical complications, with minimal patient-reported discomfort. At 3 years postoperative, ideal functional and esthetic outcomes were observed. PADM seems to be a promising xenogeneic soft tissue substitute. Further studies with a higher number of patients and defects are necessary to confirm the present findings.

Influence of the width of keratinized tissue on the development and resolution of experimental peri-implant mucositis lesions in humans.

OBJECTIVES: To analyze the influence of the width of keratinized mucosa (KM) on the development and resolution of experimental peri-implant mucositis lesions at abutments with different microstructures in humans. MATERIAL AND METHODS: In a randomized, controlled study, a total of 28 patients had received 28 target implants exhibiting a KM ≥2 mm. These were randomly connected with either partially microgrooved- (test) (n = 15) or machined (control) (n = 13) healing abutments. The study protocol included a wound healing period (WH) following implant placement (12 weeks), a plaque exposure phase (EP) of 21 days (EPd21) and a resolution phase (RP) including visits at 2, 4, and 16 weeks (RPw2; RPw4; RPw16) following plaque removal. Linear regression analyses were used to analyze the relationship between the width of KM and clinical outcomes (i.e., modified plaque index [mPI], modified gingival index [mGI], bleeding on probing [BOP], and probing depth [PD]). RESULTS: Mean and median KM values (end of WH) were 5.9 ± 2.6 and 5.0 mm (min: 2 mm; max: 10 mm; interquartile range: 5 mm) at test- and 5.5 ± 2.6 and 4.0 mm (min: 3 mm; max: 11 mm interquartile range: 4 mm) at control abutments. The linear regression analysis revealed significant correlations between the width of KM and mPI (test: RPw2; control: RPw16), mGI (test: RPw16), BOP (both: RPw16), and PD (test: RPw16; control: EPd21, RPw2, RPw4, RPw16) scores. CONCLUSION: The width of KM (≥2 mm) had some effects on the development (i.e., at 21 days) and resolution of experimental peri-implant mucositis lesions at both abutment types.

Onset, progression and resolution of experimental peri-implant mucositis at different abutment surfaces: A randomized controlled two-centre study.

OBJECTIVES: To assess the onset, progression and resolution of experimentally induced peri-implant mucositis lesions at abutments with different microstructures in humans. MATERIAL & METHODS: In a randomized, controlled, interventional two-centre study, a total of 28 patients had received 28 target implants and were randomly allocated to either partially microgrooved (test) or machined (control) healing abutments. The study was accomplished in three phases, including a wound healing period (WH) following implant placement (12 weeks), a plaque exposure phase (EP-21 days) and a resolution phase (RP-16 weeks). Clinical (e.g. bleeding on probing-BOP), immunological (MMP-8) and microbiological (DNA counts for 11 species) parameters were evaluated. RESULTS: The incidence of peri-implant mucositis at EPd21 was comparable in both test and control groups (60.0% versus 61.5%), but markedly lower at control abutments after a nonsurgical treatment and reconstitution of oral hygiene measures at RPw16 (46.7% versus 15.4%). At any follow-up visit (i.e. EP and RP), clinical parameters, MMP-8 levels and DNA counts of major bacterial species were not significantly different between both groups. CONCLUSION: The onset, progression and resolution of experimental peri-implant mucositis lesions were comparable in both groups.

Experimental peri-implant mucositis at different implant surfaces.

OBJECTIVES: To histologically and immunologically assess experimental peri-implant mucositis at surface enhanced modified (mod) hydrophilic titanium implants. MATERIALS AND METHODS: In a split-mouth design (n = 6 foxhounds), four different implants were inserted on each side of the maxilla: three titanium-zirconium alloy implants (TiZr) with either modSLA (sand-blasted, acid etched and chemically mod), modMA (machined, acid etched and chemically mod), or M (machined) surfaces in the transmucosal portion, and one titanium implant with a machined transmucosal portion (TiM). Experimental mucositis was induced at one randomly assigned side (NPC), whereas the contra-lateral maxillary side received mechanical plaque removal three times per week (PC). At 16 weeks, tissue biopsies were processed for histological (primary outcome: apical extension of the inflammatory cell infiltrate measured from the mucosal margin - PM-aICT) and immunohistochemical (CD68 antigen reactivity) analyses. Peri-implant sulcus fluid was analysed for interleukin (IL)-1ß, IL-8, matrix metalloproteinase (MMP)-8 and myeloperoxidase (MPO). RESULTS: Mean PM-aICT values varied between 1.86 (TiZrmodSLA) and 3.40 mm (TiM) in the UPC group, and between 0.88 (TiZrmodSLA) and 2.08 mm (TiZrM) in the PC group. Mean CD68, IL-1ß, IL-8, MMP-8 and MPO values were equally distributed between mod- and control implants in both NPC and PC groups. CONCLUSIONS: The progression of experimental mucositis was comparable at all implant surfaces investigated.