Journal of Periodontal and Implant Science

  • 제54권5호
  • /
  • Pages.359-373
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  • 2024
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  • 2093-2278(pISSN)
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  • 2093-2286(eISSN)
대한치주과학회 (Korean Academy of Periodontology)
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Soft-tissue volume augmentation using a connective tissue graft and a volume-stable collagen matrix with polydeoxyribonucleotide for immediate implant placement: a pilot study in a dog model

  • Han-kyu Lee (Department of Dentistry, Graduate School, Kyung Hee University) ;
  • Ji-Youn Hong (Department of Periodontology, Periodontal-Implant Clinical Research Institute, Kyung Hee University College of Dentistry, Kyung Hee University Medical Center) ;
  • Seung-Il Shin (Department of Periodontology, Periodontal-Implant Clinical Research Institute, Kyung Hee University College of Dentistry, Kyung Hee University Medical Center) ;
  • Yeek Herr (Department of Periodontology, Periodontal-Implant Clinical Research Institute, Kyung Hee University College of Dentistry, Kyung Hee University Medical Center) ;
  • Hyun-Chang Lim (Department of Periodontology, Periodontal-Implant Clinical Research Institute, Kyung Hee University College of Dentistry, Kyung Hee University Medical Center) ;
  • Jong-Hyuk Chung (Department of Periodontology, Periodontal-Implant Clinical Research Institute, Kyung Hee University College of Dentistry, Kyung Hee University Medical Center)
  • 투고 : 2024.01.09
  • 심사 : 2024.03.15
  • 발행 : 2024.10.30
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초록

Purpose: The aims of this study were 1) to investigate the effects of a subepithelial connective tissue graft (SCTG) and a volume-stable collagen matrix (VCMX) on soft-tissue volume gain in the immediate implant placement protocol, and 2) to determine whether polydeoxyribonucleotide (PDRN) can enhance the effects of a VCMX. Methods: Dental implants were placed in 4 mongrel dogs immediately after extracting the distal roots of their third and fourth mandibular premolars. The gap between the implant and the buccal bone plate was filled with synthetic bone substitute particles. The following soft-tissue augmentation modalities were applied buccally: 1) control (no augmentation), 2) SCTG, 3) VCMX, and 4) VCMX/PDRN. After 4 months, histomorphometric analysis was performed. Tissue changes were evaluated using superimposed standard tessellation language (STL) files. Results: Wound dehiscence was found in more than half of the test groups, but secondary wound healing was successfully achieved in all groups. Histomorphometrically, tissue thickness was favored in group SCTG at or above the implant platform level (IP), and group SCTG and the groups with VCMX presented similar tissue thickness below the IP. However, the differences in such thickness among the groups were minor. The keratinized tissue height was greater in group VCMX/PDRN than in groups SCTG and VCMX. Superimposing the STL files revealed a decrease in soft-tissue volume in all groups. Conclusions: Wound dehiscence after soft-tissue volume augmentation might be detrimental to obtaining the expected outcomes. PDRN appears not to have a positive effect on the soft-tissue volume gain.

키워드

과제정보

This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT) (No.2020R1C1C1008201). The PDRN and bone substitute were kindly provided by Genoss, Suwon, Korea. The dental implants were kindly provided by Dentium, Seoul, Korea.

참고문헌

  1. Araujo MG, Lindhe J. Dimensional ridge alterations following tooth extraction. An experimental study in the dog. J Clin Periodontol 2005;32:212-8.
  2. Tan WL, Wong TL, Wong MC, Lang NP. A systematic review of post-extractional alveolar hard and soft tissue dimensional changes in humans. Clin Oral Implants Res 2012;23 Suppl 5:1-21.
  3. Pommer B, Valkova V, Ubaidha Maheen C, Furhauser L, Rausch-Fan X, Seeman R. Scientific interests of 21st century clinical oral implant research: topical trend analysis. Clin Implant Dent Relat Res 2016;18:850-6.
  4. Botticelli D, Berglundh T, Lindhe J. Hard-tissue alterations following immediate implant placement in extraction sites. J Clin Periodontol 2004;31:820-8.
  5. Araujo MG, Linder E, Lindhe J. Bio-Oss collagen in the buccal gap at immediate implants: a 6-month study in the dog. Clin Oral Implants Res 2011;22:1-8.
  6. Chen ST, Wilson TG Jr, Hammerle CH. Immediate or early placement of implants following tooth extraction: review of biologic basis, clinical procedures, and outcomes. Int J Oral Maxillofac Implants 2004;19 Suppl:12-25.
  7. Kan JY, Rungcharassaeng K, Lozada JL, Zimmerman G. Facial gingival tissue stability following immediate placement and provisionalization of maxillary anterior single implants: a 2- to 8-year followup. Int J Oral Maxillofac Implants 2011;26:179-87.
  8. Lim HC, Paeng KW, Kim MJ, Jung RE, Hammerle CH, Jung UW, et al. Immediate implant placement in conjunction with guided bone regeneration and/or connective tissue grafts: an experimental study in canines. J Periodontal Implant Sci 2022;52:170-80.
  9. Bianchi AE, Sanfilippo F. Single-tooth replacement by immediate implant and connective tissue graft: a 1-9-year clinical evaluation. Clin Oral Implants Res 2004;15:269-77.
  10. Covani U, Bortolaia C, Barone A, Sbordone L. Bucco-lingual crestal bone changes after immediate and delayed implant placement. J Periodontol 2004;75:1605-12.
  11. Chen ST, Buser D. Esthetic outcomes following immediate and early implant placement in the anterior maxilla--a systematic review. Int J Oral Maxillofac Implants 2014;29 Suppl:186-215.
  12. Cosyn J, Hooghe N, De Bruyn H. A systematic review on the frequency of advanced recession following single immediate implant treatment. J Clin Periodontol 2012;39:582-9.
  13. Cosyn J, Eghbali A, Hermans A, Vervaeke S, De Bruyn H, Cleymaet R. A 5-year prospective study on single immediate implants in the aesthetic zone. J Clin Periodontol 2016;43:702-9.
  14. Hosseini M, Worsaae N, Gotfredsen K. Tissue changes at implant sites in the anterior maxilla with and without connective tissue grafting: a five-year prospective study. Clin Oral Implants Res 2020;31:18-28.
  15. Levine RA, Ganeles J, Kan J, Fava PL. 10 Keys for successful esthetic-zone single implants: importance of biotype conversion for lasting success. Compend Contin Educ Dent 2018;39:522-9.
  16. Thoma DS, Buranawat B, Hammerle CH, Held U, Jung RE. Efficacy of soft tissue augmentation around dental implants and in partially edentulous areas: a systematic review. J Clin Periodontol 2014;41 Suppl 15:S77-91.
  17. Thoma DS, Benic GI, Zwahlen M, Hammerle CH, Jung RE. A systematic review assessing soft tissue augmentation techniques. Clin Oral Implants Res 2009;20 Suppl 4:146-65.
  18. Thoma DS, Zeltner M, Hilbe M, Hammerle CH, Husler J, Jung RE. Randomized controlled clinical study evaluating effectiveness and safety of a volume-stable collagen matrix compared to autogenous connective tissue grafts for soft tissue augmentation at implant sites. J Clin Periodontol 2016;43:874-85.
  19. Thoma DS, Naenni N, Benic GI, Hammerle CH, Jung RE. Soft tissue volume augmentation at dental implant sites using a volume stable three-dimensional collagen matrix - histological outcomes of a preclinical study. J Clin Periodontol 2017;44:185-94.
  20. Naenni N, Bienz SP, Benic GI, Jung RE, Hammerle CH, Thoma DS. Volumetric and linear changes at dental implants following grafting with volume-stable three-dimensional collagen matrices or autogenous connective tissue grafts: 6-month data. Clin Oral Investig 2018;22:1185-95.
  21. Cosyn J, Blanco J. EAO position paper: immediate implant placement: managing hard and soft tissue stability from diagnosis to prosthetic treatment. Int J Prosthodont 2023;36:533-45.
  22. Hammerle CH, Jepsen K, Sailer I, Strasding M, Zeltner M, Cordaro L, et al. Efficacy of a collagen matrix for soft tissue augmentation after implant placement compared to connective tissue grafts: a multicenter, noninferiority, randomized controlled trial. Clin Oral Implants Res 2023;34:999-1013.
  23. 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.
  24. Bitto A, Galeano M, Squadrito F, Minutoli L, Polito F, Dye JF, et al. Polydeoxyribonucleotide improves angiogenesis and wound healing in experimental thermal injury. Crit Care Med 2008;36:1594-602.
  25. Galeano M, Bitto A, Altavilla D, Minutoli L, Polito F, Calo M, et al. Polydeoxyribonucleotide stimulates angiogenesis and wound healing in the genetically diabetic mouse. Wound Repair Regen 2008;16:208-17.
  26. Lee DW, Hong HJ, Roh H, Lee WJ. The effect of polydeoxyribonucleotide on ischemic rat skin flap survival. Ann Plast Surg 2015;75:84-90.
  27. Shin SM, Baek EJ, Kim KH, Kim KJ, Park EJ. Polydeoxyribonucleotide exerts opposing effects on ERK activity in human skin keratinocytes and fibroblasts. Mol Med Rep 2023;28:148.
  28. Lee KS, Shin SY, Hammerle CHF, 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.
  29. Lim HC, Kim CH, Lee HK, Jeon G, Herr Y, Chung JH. Effect of polydeoxyribonucleotide with xenogeneic collagen matrix on gingival phenotype modification: a pilot preclinical study. J Periodontal Implant Sci 2023;53:417-28.
  30. 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.
  31. Caneva M, Botticelli D, Vigano P, Morelli F, Rea M, Lang NP. Connective tissue grafts in conjunction with implants installed immediately into extraction sockets. An experimental study in dogs. Clin Oral Implants Res 2013;24:50-6.
  32. Thoma DS, Hammerle CH, Cochran DL, Jones AA, Gorlach C, Uebersax L, et al. Soft tissue volume augmentation by the use of collagen-based matrices in the dog mandible -- a histological analysis. J Clin Periodontol 2011;38:1063-70.
  33. Aldhohrah T, Qin G, Liang D, Song W, Ge L, Mashrah MA, et al. Does simultaneous soft tissue augmentation around immediate or delayed dental implant placement using sub-epithelial connective tissue graft provide better outcomes compared to other treatment options? A systematic review and metaanalysis. PLoS One 2022;17:e0261513.
  34. De Angelis P, Manicone PF, Rella E, Liguori MG, De Angelis S, Tancredi S, et al. The effect of soft tissue augmentation on the clinical and radiographical outcomes following immediate implant placement and provisionalization: a systematic review and meta-analysis. Int J Implant Dent 2021;7:86.
  35. Raghoebar GM, Korfage A, Meijer HJA, Gareb B, Vissink A, Delli K. Linear and profilometric changes of the mucosa following soft tissue augmentation in the zone of aesthetic priority: a systematic review and meta-analysis. Clin Oral Implants Res 2021;32 Suppl 21:138-56.
  36. Seyssens L, De Lat L, Cosyn J. Immediate implant placement with or without connective tissue graft: a systematic review and meta-analysis. J Clin Periodontol 2021;48:284-301.
  37. Linkevicius T, Linkevicius R, Alkimavicius J, Linkeviciene L, Andrijauskas P, Puisys A. Influence of titanium base, lithium disilicate restoration and vertical soft tissue thickness on bone stability around triangular-shaped implants: a prospective clinical trial. Clin Oral Implants Res 2018;29:716-24.
  38. Cosyn J, Eeckhout C, De Bruyckere T, Eghbali A, Vervaeke S, Younes F, et al. A multi-centre randomized controlled trial comparing connective tissue graft with collagen matrix to increase soft tissue thickness at the buccal aspect of single implants: 1-year results. J Clin Periodontol 2022;49:911-21.
  39. Zeltner M, Jung RE, Hammerle CH, Husler J, Thoma DS. Randomized controlled clinical study comparing a volume-stable collagen matrix to autogenous connective tissue grafts for soft tissue augmentation at implant sites: linear volumetric soft tissue changes up to 3 months. J Clin Periodontol 2017;44:446-53.
  40. Becker J, Al-Nawas B, Klein MO, Schliephake H, Terheyden H, Schwarz F. Use of a new cross-linked collagen membrane for the treatment of dehiscence-type defects at titanium implants: a prospective, randomized-controlled double-blinded clinical multicenter study. Clin Oral Implants Res 2009;20:742-9.