Journal of Periodontal and Implant Science

Korean Academy of Periodontology (대한치주과학회)
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Effect of polydeoxyribonucleotide with xenogeneic collagen matrix on gingival phenotype modification: a pilot preclinical study

  • Hyun-Chang Lim (Department of Periodontology, College of Dentistry, Kyung Hee University, Periodontal-Implant Clinical Research Institute, Kyung Hee University Medical Center) ;
  • Chang-Hoon Kim (Department of Dentistry, Graduate School, Kyung Hee University) ;
  • Han-Kyu Lee (Department of Dentistry, Graduate School, Kyung Hee University) ;
  • Gyewon Jeon (Department of Dentistry, Graduate School, Kyung Hee University) ;
  • Yeek Herr (Department of Periodontology, College of Dentistry, Kyung Hee University, Periodontal-Implant Clinical Research Institute, Kyung Hee University Medical Center) ;
  • Jong-Hyuk Chung (Department of Periodontology, College of Dentistry, Kyung Hee University, Periodontal-Implant Clinical Research Institute, Kyung Hee University Medical Center)
  • Received : 2023.04.07
  • Accepted : 2023.05.23
  • Published : 2023.12.31
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Abstract

Purpose: To investigate the effect of xenogeneic collagen matrix (XCM) with polydeoxyribonucleotide (PDRN) for gingival phenotype modification compared to autogenous connective tissue graft. Methods: Five mongrel dogs were used in this study. Box-type gingival defects were surgically created bilaterally on the maxillary canines 8 weeks before gingival augmentation. A coronally positioned flap was performed with either a subepithelial connective tissue graft (SCTG) or XCM with PDRN (2.0 mg/mL). The animals were sacrificed after 12 weeks. Intraoral scanning was performed for soft tissue analysis, and histologic and histomorphometric analyses were performed. Results: One animal exhibited wound dehiscence, leaving 4 for analysis. Superimposition of STL files revealed no significant difference in the amount of gingival thickness increase (ranging from 0.69±0.25 mm to 0.80±0.31 mm in group SCTG and from 0.48±0.25 mm to 0.85±0.44 mm in group PDRN; P>0.05). Histomorphometric analysis showed no significant differences between the groups in supracrestal gingival tissue height, keratinized tissue height, tissue thickness, and rete peg density (P>0.05). Conclusions: XCM soaked with PDRN yielded comparable gingival augmentation to SCTG.

Keywords

Acknowledgement

This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT) (No.2020R1C1C1008201). The PDRN was kindly provided by Genoss.

References

  1. Barootchi S, Tavelli L, Zucchelli G, Giannobile WV, Wang HL. Gingival phenotype modification therapies on natural teeth: a network meta-analysis. J Periodontol 2020;91:1386-99. https://doi.org/10.1002/JPER.19-0715
  2. Cortellini P, Bissada NF. Mucogingival conditions in the natural dentition: narrative review, case definitions, and diagnostic considerations. J Clin Periodontol 2018;45 Suppl 20:S190-8. https://doi.org/10.1111/jcpe.12948
  3. Song YW, Kim S, Waller T, Cha JK, Cho SW, Jung UW, et al. Soft tissue substitutes to increase gingival thickness: histologic and volumetric analyses in dogs. J Clin Periodontol 2019;46:96-104. https://doi.org/10.1111/jcpe.13034
  4. Rasperini G, Acunzo R, Cannalire P, Farronato G. Influence of periodontal biotype on root surface exposure during orthodontic treatment: a preliminary study. Int J Periodont Restor Dent 2015;35:665-75.
  5. Zucchelli G, Tavelli L, McGuire MK, Rasperini G, Feinberg SE, Wang HL, et al. Autogenous soft tissue grafting for periodontal and peri-implant plastic surgical reconstruction. J Periodontol 2020;91:9-16.  https://doi.org/10.1002/JPER.19-0350
  6. Chambrone L, Sukekava F, Araujo MG, Pustiglioni FE, Chambrone LA, Lima LA. Root-coverage procedures for the treatment of localized recession-type defects: a Cochrane systematic review. J Periodontol 2010;81:452-78. https://doi.org/10.1902/jop.2010.090540
  7. Chambrone L, Tatakis DN. Periodontal soft tissue root coverage procedures: a systematic review from the AAP Regeneration Workshop. J Periodontol 2015;86 Suppl:S8-51. https://doi.org/10.1902/jop.2015.130674
  8. Zuhr O, Baumer D, Hurzeler M. The addition of soft tissue replacement grafts in plastic periodontal and implant surgery: critical elements in design and execution. J Clin Periodontol 2014;41 Suppl 15:S123-42. https://doi.org/10.1111/jcpe.12185
  9. Tavelli L, Barootchi S, Rasperini G, Giannobile WV. Clinical and patient-reported outcomes of tissue engineering strategies for periodontal and peri-implant reconstruction. Periodontol 2000 2023;91:217-69. https://doi.org/10.1111/prd.12446
  10. Pietruska M, Skurska A, Podlewski L, Milewski R, Pietruski J. Clinical evaluation of Miller class I and II recessions treatment with the use of modified coronally advanced tunnel technique with either collagen matrix or subepithelial connective tissue graft: a randomized clinical study. J Clin Periodontol 2019;46:86-95. https://doi.org/10.1111/jcpe.13031
  11. Lee KS, Shin SY, Hammerle CH, Jung UW, Lim HC, Thoma DS. Dimensional ridge changes in conjunction with four implant timing protocols and two types of soft tissue grafts: a pilot pre-clinical study. J Clin Periodontol 2022;49:401-11. https://doi.org/10.1111/jcpe.13594
  12. Schmitt CM, Matta RE, Moest T, Humann J, Gammel L, Neukam FW, et al. Soft tissue volume alterations after connective tissue grafting at teeth: the subepithelial autologous connective tissue graft versus a porcine collagen matrix - a pre-clinical volumetric analysis. J Clin Periodontol 2016;43:609-17. https://doi.org/10.1111/jcpe.12547
  13. Cha JK, Sun YK, Lee JS, Choi SH, Jung UW. Root coverage using porcine collagen matrix with fibroblast growth factor-2: a pilot study in dogs. J Clin Periodontol 2017;44:96-103. https://doi.org/10.1111/jcpe.12644
  14. Galeano M, Pallio G, Irrera N, Mannino F, Bitto A, Altavilla D, et al. Polydeoxyribonucleotide: a promising biological platform to accelerate impaired skin wound healing. Pharmaceuticals (Basel) 2021;14:1103.
  15. Kim TH, Heo SY, Oh GW, Heo SJ, Jung WK. Applications of marine organism-derived polydeoxyribonucleotide: its potential in biomedical engineering. Mar Drugs 2021;19:296.
  16. Squadrito F, Bitto A, Irrera N, Pizzino G, Pallio G, Minutoli L, et al. Pharmacological activity and clinical use of PDRN. Front Pharmacol 2017;8:224.
  17. An J, Park SH, Ko IG, Jin JJ, Hwang L, Ji ES, et al. Polydeoxyribonucleotide ameliorates lipopolysaccharide-induced lung injury by inhibiting apoptotic cell death in rats. Int J Mol Sci 2017;18:1847.
  18. Jeong W, Yang CE, Roh TS, Kim JH, Lee JH, Lee WJ. Scar prevention and enhanced wound healing induced by polydeoxyribonucleotide in a rat incisional wound-healing model. Int J Mol Sci 2017;18:1698.
  19. Lee DW, Hyun H, Lee S, Kim SY, Kim GT, Um S, et al. The effect of polydeoxyribonucleotide extracted from salmon sperm on the restoration of bisphosphonate-related osteonecrosis of the jaw. Mar Drugs 2019;17:51.
  20. Shin DY, Park JU, Choi MH, Kim S, Kim HE, Jeong SH. Polydeoxyribonucleotide-delivering therapeutic hydrogel for diabetic wound healing. Sci Rep 2020;10:16811.
  21. Kilkenny C, Browne W, Cuthill IC, Emerson M, Altman DG; NC3Rs Reporting Guidelines Working Group. Animal research: reporting in vivo experiments: the ARRIVE guidelines. Br J Pharmacol 2010;160:1577-9. https://doi.org/10.1111/j.1476-5381.2010.00872.x
  22. Kao RT, Curtis DA, Kim DM, Lin GH, Wang CW, Cobb CM, et al. American Academy of Periodontology best evidence consensus statement on modifying periodontal phenotype in preparation for orthodontic and restorative treatment. J Periodontol 2020;91:289-98. https://doi.org/10.1002/JPER.19-0577
  23. Thoma DS, Alshihri A, Fontolliet A, Hammerle CH, Jung RE, Benic GI. Clinical and histologic evaluation of different approaches to gain keratinized tissue prior to implant placement in fully edentulous patients. Clin Oral Investig 2018;22:2111-9. https://doi.org/10.1007/s00784-017-2319-4
  24. Lorenzo R, Garcia V, Orsini M, Martin C, Sanz M. Clinical efficacy of a xenogeneic collagen matrix in augmenting keratinized mucosa around implants: a randomized controlled prospective clinical trial. Clin Oral Implants Res 2012;23:316-24. https://doi.org/10.1111/j.1600-0501.2011.02260.x
  25. Sanz M, Lorenzo R, Aranda JJ, Martin C, Orsini M. Clinical evaluation of a new collagen matrix (Mucograft prototype) to enhance the width of keratinized tissue in patients with fixed prosthetic restorations: a randomized prospective clinical trial. J Clin Periodontol 2009;36:868-76. https://doi.org/10.1111/j.1600-051X.2009.01460.x
  26. Tarasenko S, Ashurko I, Taschieri S, Repina S, Esaya N A, Corbella S. Comparative analysis of methods to increase the amount of keratinized mucosa before stage-two surgery: a randomized controlled study. Quintessence Int 2020;51:374-87.
  27. Lim HC, An SC, Lee DW. A retrospective comparison of three modalities for vestibuloplasty in the posterior mandible: apically positioned flap only vs. free gingival graft vs. collagen matrix. Clin Oral Investig 2018;22:2121-8. https://doi.org/10.1007/s00784-017-2320-y
  28. Qiu X, Li X, Li F, Hu D, Wen Z, Wang Y, et al. Xenogeneic collagen matrix versus free gingival graft for augmenting keratinized mucosa around posterior mandibular implants: a randomized clinical trial. Clin Oral Investig 2023;27:1953-64. https://doi.org/10.1007/s00784-022-04853-8
  29. Cardaropoli D, Tamagnone L, Roffredo A, Gaveglio L. Treatment of gingival recession defects using coronally advanced flap with a porcine collagen matrix compared to coronally advanced flap with connective tissue graft: a randomized controlled clinical trial. J Periodontol 2012;83:321-8. https://doi.org/10.1902/jop.2011.110215
  30. Aroca S, Molnar B, Windisch P, Gera I, Salvi GE, Nikolidakis D, et al. Treatment of multiple adjacent Miller class I and II gingival recessions with a Modified Coronally Advanced Tunnel (MCAT) technique and a collagen matrix or palatal connective tissue graft: a randomized, controlled clinical trial. J Clin Periodontol 2013;40:713-20. https://doi.org/10.1111/jcpe.12112
  31. Choi JJ, Zwirner J, Ramani RS, Ma S, Hussaini HM, Waddell JN, et al. Mechanical properties of human oral mucosa tissues are site dependent: A combined biomechanical, histological and ultrastructural approach. Clin Exp Dent Res 2020;6:602-11. https://doi.org/10.1002/cre2.305
  32. Vignoletti F, Nunez J, de Sanctis F, Lopez M, Caffesse R, Sanz M. Healing of a xenogeneic collagen matrix for keratinized tissue augmentation. Clin Oral Implants Res 2015;26:545-52. https://doi.org/10.1111/clr.12441
  33. Grossman ES, Forbes ME. Studies related to reaction of supporting soft tissue to denture wear: the histological response of vervet monkey oral epithelium to a -80 mmHg vacuum. J Oral Rehabil 1990;17:587-97. https://doi.org/10.1111/j.1365-2842.1990.tb01430.x