Daniele Cardaropoli

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.

BACKGROUND Connective tissue graft (CTG) plus coronally advanced flap (CAF) is the reference therapy for root coverage. The aim of the present study is to evaluate the use of a porcine collagen matrix (PCM) plus CAF as an alternative to CTG+CAF for the treatment of gingival recessions (REC), in a prospective randomized, controlled clinical trial. METHODS Eighteen adult patients participated in this study. The patients presented 22 single Millers Class I or II REC, randomly assigned to the test (PCM+CAF) or control (CTG+CAF) group. REC, probing depth, clinical attachment level (CAL), and width of keratinized tissue (KG) were evaluated at 12 months. In addition, the gingival thickness (GT) was measured 1mm apical to the bottom of the sulcus. RESULTS At 12 months, mean REC was 0.23 mm for test sites and 0.09 mm for control sites (P <0.01), whereas percentage of root coverage was 94.32% and 96.97%, respectively. CAL gain was 2.41 mm in test sites and 2.95 mm in control sites (P <0.01). KG gain was 1.23 mm in the test group and 1.27 mm in the control group (P <0.01). In test sites, GT changed from 0.82 to 1.82 mm, and in control sites, from 0.86 to 2.09 mm (P <0.01). CONCLUSIONS Within the limits of the study, both treatment procedures resulted in significant reduction in REC at 12 months. No statistically significant differences were found between PCM+CAF and CTG+CAF with regard to any clinical parameter. The collagen matrix represents a possible alternative to CTG.

Relationship between the buccal bone plate thickness and the healing of postextraction sockets with/without ridge preservation.

In 48 postextraction sites, sockets were grafted with bovine bone mineral plus collagen membrane (test) or had spontaneous healing (control). After 4 months, horizontal ridge width reduction was 0.71 mm in the test group and 4.04 mm in the control group, while vertical ridge loss was 0.58 mm and 1.67 mm, respectively. No correlation was found between the thickness of the buccal bone wall and the alveolar bone loss in the test group, while an inverse correlation was found in the control group. Ridge preservation compensated for postextraction alveolar ridge resorption irrespective of the buccal plate thickness, whereas leaving the extraction socket undisturbed may result in alveolar bone loss.

Soft tissue contour changes at immediate postextraction single-tooth implants with immediate restoration: a 12-month prospective cohort study.

In the maxillary arch from premolar to premolar, 26 single dental implants were inserted in fresh extraction sockets and immediately provisionalized. The bone-to-implant gap was grafted with a bovine bone mineral. After 3 months, definitive ceramic crowns were placed. At baseline and after 1 year, the soft tissue horizontal width, mesiodistal papillary level, midfacial gingival level, and pink esthetic score were evaluated. No statistical differences were found between baseline and 1 year for all parameters. Immediate single-tooth implants, with immediate restoration, are capable of maintaining the soft tissue contour and esthetics compared to the pretreatment status.

Vertical ridge augmentation with a collagen membrane, bovine bone mineral and fibrin sealer: clinical and histologic findings.

This study evaluated the treatment of alveolar bone deficiencies combined with dental implant placement. Thirty-five endosseous implants were inserted into 20 patients. After implant placement, the mean height of the supracrestal bone defects measured 4.25 ± 1.34 mm. Bone regeneration procedures were performed using a combination of a bovine bone-derived mineral stabilized with a fibrin-fibronectin sealing system and covered with a bilayered porcine collagen membrane. Healing was uneventful in all instances with maintenance of primary closure throughout the healing period. Stage-two surgery was performed after 6 months, and a hard bonelike tissue was detectable at the defect sites. Histologic examination confirmed the presence of newly formed bone with residual particles of xenograft. The mean bone gain was 3.95 ± 1.47 mm. The positive outcomes in terms of bone regeneration and low complication rate demonstrated the potential of this technique for the treatment of supracrestal ridge deficiencies. Bovine bone mineral combined with a fibrin sealer and protected by a collagen membrane should be considered as an alternative in the treatment of vertical peri-implant bone defects.

Evaluation of Dental Implants Placed in Preserved and Nonpreserved Postextraction Ridges: A 12-Month Postloading Study.

Forty-eight single dental implants were inserted 4 months after tooth extraction following ridge preservation (RP; n = 24) or spontaneous healing (EXT; n = 24). During surgery, 1 (7%) of 24 implants in the RP group and 14 (58%) of 24 in the EXT group required additional bone grafting, and the implant stability quotient value was similar in the two groups. The survival rate of the implants in both groups was 100% at the 1-year follow-up. The success rate was 95.83% in the RP group and 91.66% in the EXT group. No statistically significant differences in the marginal bone level were detected between the two groups. Similar outcomes of implants inserted in preserved or spontaneously healed ridges can be anticipated, but the use of an RP procedure reduces the need for further bone augmentation.

Soft tissue contour changes at immediate implants: a randomized controlled clinical study.

In 52 patients, single anterior teeth were extracted and replaced by immediate implants. The peri-implant gap was left either untreated (control) or was grafted and covered with a membrane (test group). After 12 months the horizontal bone resorption was significantly lower in the test group (test sites: 0.69 ± 0.68 mm, 8.13%; control sites: 1.92 ± 1.02 mm, 21.62%; P = .001), and there was less reduction in ridge height (test sites: 0.58 ± 0.77 mm; control sites: 1.69 ± 1.74 mm;P = .004). Ridge preservation considerably limited the amount of horizontal and vertical soft tissue alterations when compared with implant placement alone.

Alveolar Ridge Preservation Using Tridimensional Collagen Matrix and Deproteinized Bovine Bone Mineral in the Esthetic Area: A CBCT and Histologic Human Pilot Study

Alveolar ridge preservation is of great importance for successful implant therapy. This study investigated the effects of a xenogeneic tridimensional collagen matrix (CM) in conjunction with deproteinized bovine bone mineral blended with 10% collagen (DBBM-C) on the healing of 12 intact extraction sockets in the esthetic area. Cone beam computed tomograpy examinations revealed nearly stable alveolar ridge dimensions (> 90% of the ridge horizontal dimension was preserved). New bone formation of approximately 45% and adequate resorption of the grafted material were histologically observed. Thus, application of CM together with DBBM-C using minimally invasive flapless approach can preserve the original ridge volume and support bone formation, contributing to adequate bone volume for implant insertion.