Use of Xenogenic Collagen Matrices in Peri-Implant Soft Tissue Volume Augmentation: A Critical Review on the Current Evidence and New Technique Presentation
Abstract
:1. Introduction
2. Materials and Methods
2.1. Assessments of the Risk of Bias
2.2. Statistical Analysis
3. Results
General Overview of the Results of RCT Which Compared XCMs (Test) Versus CTGs (Control) | ||||
---|---|---|---|---|
Study | PAS (VAS on a 0 to 100) | Changes in PKMW between Baseline and Final Follow-Up (mm) | Changes in PD between Baseline and Final Follow-Up (mm) | Comments by Authors |
Sanz et al. [20] | N.R | CTG 2.6 ± 0.96 XCM 2.5 ± 0.7 | N.R. | The XCM was as effective and predictable as the CTG for attaining a band of keratinized tissue, but its use was associated with a significantly lower patient morbidity. |
Lorenzo et al. [21] | N.R | CTG 2.33 ± 1.03 XCM 2.3 ± 0.47 | CTG 0 ± 1.03 XCM 0.4 ± 0.62 | The results of the study demonstrate that the use of XCM presented similar results to the CTG for the KM band gain. |
Thoma et al. [22] | 0–10 | CTG 0.8 ± 1.8 o. 0.8 ± 2.2 b. 1.6 ± 2.6 a. XCM 1.4 ± 1.4 o. 1.1 ± 1.4 b. 0.9 ± 1.9 a | N.R | The XCM was as effective and predictable as the CTG for attaining a band of keratinized tissue |
Zeitner et al. [23] | 0–10 | CTG 4.2 ± 1.9 o. 4.1 ± 2.0 b. 3.4 ± 1.8 a. XCM 3.4 ± 1.0 o. 2.9 ± 1.5 b. 2.6 ± 2.3 a. | N.R | The use of XCM and the subepithelial connective tissue graft for soft tissue augmentation at implant sites rendered a similar gain in soft tissue volume |
Cairo et al. [24] | CTG 90 ± 9.0 XCM 90 ± 8.0 | CTG 0.9 ± 1.6 XC 1.2 ± 1.2 | CTG 2.9 ± 0.3 XCM 2.8 ± 0.2 | Similar gain in keratinized tissue and in the peri-implant soft tissue thickness |
Puzio et al. [25] | N R | (change) CTG 1.52 ± 1.0 XCM 0.89 ± 0.6 | N R | Both XCM and CTG increase the keratinized tissue but higher values were noted using CTG |
Huber et al. [26] | N R | CTG 3.2 ± 0.8 XCM 2.1 ± 1.2 | N R | The buccal peri-implant soft tissue dimensions at implant sites revealed only minimal changes without relevant differences between sites that had previously been grafted with XCM or CTG. |
General overview of the results of prospective studies which investigated XCMs. | ||||
Papi & Pompa [27] | NR | XCM 4.32 ± 1.22 | 0.38 ± 0.21 | With XCM, the keratinized tissue width can be augmented, and the width remains stable for the assessment period of 12 months. |
Schallhorn et al. [28] | 90 ± 20 | XCM 2.1 ± 1.0 | 3.0 ± 1.6 | XCM demonstrated the potential to increase KMW and GT around existing dental implants. |
4. Discussion
Study | Sample | Study Design | Follow-Up Time | Keratinized Mucosa Width Gain (mm) | Soft Tissue Thickness Gain (mm) |
---|---|---|---|---|---|
Papi et al. [27] | 12 patients | Prospective cohort study | 12 months | N R | PDXCM: 1.25 |
Zafiropoulos et al. [38] | 27 patients | Prospective, randomized examiner-blinded controlled clinical study | 6 months | N R | PDXCM: 1.06 |
Stefanini et al. [39] | 10 patients | Case series | 12 months | PDXCM 0.65 ± 0.41 | PDXCM: 1.2 ± 0.18 |
Papi and Pompa 12 [40] | 12 patients | Prospective pilot cohort study | 12 months | PDXCM: 4.32 | N R |
Schmitt et al. [41] | 14 patients | Controlled clinical trial | 6 months | N R | PDXCM: 0.30 ± 0.16 |
Verardi et al. [42] | 24 patients 24 implants | Prospective study | 6 months | PDXCM 1.33 ± 0.71 | N R |
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Identification of Studies via Databases and Registers | ||||
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Identification | Records identified from PubMed searching: (n = 87) | Records identified from Scopus searching: (n = 77) | Records identified from Cochrane Library: (n = 75) | Records identified from Web of Sciences: (n = 5) |
| | | | |
Screening | Records after duplicates removed (n = 133) | |||
| ||||
Records screened (n = 133) | | Records excluded by title and abstract (n = 122) | ||
| ||||
Full text assessed for eligibility | | Full text excluded after full text assessed (n = 4) Reasons for exclusion: no comparison between CTG and XCM | ||
| ||||
Included | Studies included in review (n = 7) |
General Overview of RCT Which Compared XCMs Versus CTGs | ||||||
---|---|---|---|---|---|---|
Study | Follow-Up | Patients/Implants | Systemic Periodontal Status Smoking | Time of Surgery | Outcomes Measurements | XCM |
Sanz et al. [20] | 1,3,6 months | P = 14 I = 14 | Systemic, Periodontally healthy FMPI < 20% Smokers < 10 sig.die | After crown placement | PKMW, PPD, CAL, GI, PI, pain, PAS | Mucograft® |
Lorenzo et al. [21] | 6 months | P = 24 I = 24 | Systemic, Periodontally healthy FMPI < 20% Smokers < 10 sig.die | After crown placement | PKMW, GI, PI, PD, CAL | Mucograft® |
Thoma et al. [22] | 3 months | P = 20 I = 20 | Systemic, Periodontally healthy FMPI < 20% Smokers < 10 sig.die | After implant placement. From 6 weeks to 6 months before | PKMM, PPD, CAL, BOP, PI | Mucograft® |
Zeitner et al. [23] | 3 months | P = 20 I = 20 | Systemic, Periodontally healthy FMPI < 20% Smokers < 10 sig.die | After implant placement. From 6 weeks to 6 months before | PKMM, PPD, CAL, BOP, PI | Mucograft® |
Cairo et al. [24] | 6 months | P = 60 I = 60 | Systemic, Periodontally healthy FMPI < 15% PPD < 5mm Smokers < 10 sig.die | During second surgery implant uncovering | PKMW, GT, PD, PAS | Mucograft® |
Puzio et al. [25] | 12 months | P = 22 I = 30 | Systemic, Periodontally healthy PI < 20% FMBS < 15% Smokers < 10 sig.die | During second surgery implant uncovering | PKMW, GT | Mucograft® |
Huber et al. [26] | 12 months | P = 20 I = 20 | Systemic, Periodontally healthy Smokers < 10 sig.die | During second surgery implant uncovering | PKMW, GT | Mucograft® |
General overview of prospective studies which investigated XCMs | ||||||
Pompa & Papi. [27] | 12 months | P = 12 I = 10 | Systemic, Periodontally healthy FMPI < 20% Smokers < 10 sig.die | After crown placement | KMW, PI, PD, BP | Mucoderm® |
Schallhorn et al. [28] | 6 months | P = 30 I = 32 | Systemic, Periodontally healthy FMPI < 20% Smokers < 10 sig.die | After crown placement | KMW, GT, PD, colour, PAS | Mucograft® |
Study | Adequate Sequence Generation | Allocation Concealment | Blinding | Incomplete Outcomes Data Addressed | Selective Outcome Reporting | Free of Other Source of Bias | Estimate Potential Source of Bias |
---|---|---|---|---|---|---|---|
Sanz et al. [20] | No | Yes | Yes | Yes | Yes | Yes | Low risk |
Lorenzo et al. [21] | Yes | Yes | Yes | Yes | Yes | Yes | Low risk |
Thoma et al. [22] | Yes | Yes | Yes | Yes | Yes | Yes | Low risk |
Zeitner et al. [23] | Yes | Yes | Yes | Yes | Yes | Yes | Low risk |
Cairo et al. [24] | Yes | Yes | Yes | Yes | Yes | Yes | Low risk |
Puzio et al. [25] | Yes | Yes | Yes | Yes | Yes | Yes | Low risk |
Huber et al. [26] | Yes | Yes | Yes | Yes | Yes | Yes | Low risk |
Advantages | Disadvantages | |
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CTG |
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XCMs/PDXCMs |
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De Annuntiis, C.; Testarelli, L.; Guarnieri, R. Use of Xenogenic Collagen Matrices in Peri-Implant Soft Tissue Volume Augmentation: A Critical Review on the Current Evidence and New Technique Presentation. Materials 2022, 15, 3937. https://doi.org/10.3390/ma15113937
De Annuntiis C, Testarelli L, Guarnieri R. Use of Xenogenic Collagen Matrices in Peri-Implant Soft Tissue Volume Augmentation: A Critical Review on the Current Evidence and New Technique Presentation. Materials. 2022; 15(11):3937. https://doi.org/10.3390/ma15113937
Chicago/Turabian StyleDe Annuntiis, Carlo, Luca Testarelli, and Renzo Guarnieri. 2022. "Use of Xenogenic Collagen Matrices in Peri-Implant Soft Tissue Volume Augmentation: A Critical Review on the Current Evidence and New Technique Presentation" Materials 15, no. 11: 3937. https://doi.org/10.3390/ma15113937