Soft tissue augmentation around dental implants with connective tissue graft (CTG) and xenogenic collagen matrix (XCM). 1-year randomized control trail.

BACKGROUND: The anatomy of soft tissues around dental implants is extremely important to prevent inflammatory periimplant diseases and ensure healthy, stable and long-term survival of a dental implant. Various methods and materials for increasing the physiological thickness of tissues have been described including connective tissue graft (CTG) and xenogenic collagen matrix (XCM). While assessing various materials it is necessary to establish objective measurement method to determine the minimum amount of tissue thickness to maintain a stable level of bone around the implant. The aim of the study was to determine the effect of soft tissues in the implant area on the marginal bone level in the implant area and to define of the critical gingival thickness to minimize marginal bone level (MBL) loss. METHODS: 75 bone level implants (Conelog® Camlog, Switzerland) were inserted in the aesthetic area. Thickening of soft tissues was performed using CTG and XCM. 12 months after the loading with final restoration, the thickness of soft tissues in the implant area was examined with ultrasound USG device (Pirop®, Echoson, Poland), and each implant was subjected to RVG examination, where MBL loss was determined. RESULTS: A tendency to occur less MBL loss was found when thicker gingiva was present. The higher soft tissue thickness was, the lower MBL loss has occurred. A critical value for tissue thickness was determined as TKT ≤ 2.88. CONCLUSIONS: In case of thin biotype soft tissue augmentation is required when value of tissue thickness in ultrasound measure is less than 2.88 mm.

Ultrasound assessment of soft tissue augmentation around implants in the aesthetic zone using a connective tissue graft and xenogeneic collagen matrix - 1-year randomised follow-up.

PURPOSE: A comparative, ultrasound evaluation of the thickness of keratinized mucosa (TKT) around implants one year after gingival augmentation (GA) by means of a connective tissue graft (CTG) and the xenogeneic collagen matrix (CMX). MATERIALS AND METHODS: A total of 75 bone level tapered implants (Conelog® Camlog) were inserted in 57 patients in the aesthetic area of both jaws. The patients were divided into 3 groups: control group I- without GA; group II- GA 3 months before implantation, and group III- GA 3 months after implantation. Groups II and III were divided into two subgroups depends on type of material used for GA: (a) CMX (Mucograft®, Geistlich Pharma AG) and (b) CTG. The patients underwent a clinical and ultrasound examination before, then after 3 and 12 months following GA respectively to evaluate TKT at two points using ultrasound equipment (Pirop®, Echoson). Point 1 was considered to be in the middle of the line connecting the cemento-enamel junction (CEJ) to the adjacent teeth, and point 2 on the mucogingival junction (MGJ). RESULTS: Three months after GA, the highest increase in gingival thickness was noted in group IIIb (point 1 - 0.95mm, 2 - 1.01mm). However, 12 months after GA the highest gingival thickness was observed in group IIb (point 1 - 1.76mm, 2 - 1.36m) and next IIIb (point 1 - 1.52mm, 2 - 1.15mm). CONCLUSIONS: Both CTG and Geistlich Mucograft® increased TKT, but higher values were noted using CTG augmentation before implantation. An ultrasonic device can be used as a non-invasive, reliable, and reproducible method for evaluating TKT.