Study

Novel technique to reconstruct peri-implant keratinised mucosa width using mucoderm® – Clinical Case Series

https://doi.org/10.3390/dj12030043
Horváth, A.; Windisch, P.; Palkovics, D.; Li, X. Novel Technique to Reconstruct Peri-Implant Keratinised Mucosa Width Using Xenogeneic Dermal Matrix. Clinical Case Series. Dent. J. 2024, 12, 43.

Original Title: Novel Technique to Reconstruct Peri-Implant Keratinised Mucosa Width Using Xenogeneic Dermal Matrix. Clinical Case Series

This clinical case series evaluated the efficacy of mucoderm® to widen the band of the buccal keratinised mucosa at 6- and 12-month observation periods by comparing the upper and lower jaws. mucoderm® demonstrated to be a suitable alternative to autograft, achieving a statistically significant and clinically sufficient (>2 mm) amount of new keratinised mucosa.

BACKGROUND

As the number of dental implants replacing teeth is rising, clinician encounter several challenges. The most common concerns are peri-implant mucositis and peri-implantitis. The lack of sufficient vestibulum depth and width of the attached keratinised mucosa is particularly suggested as a causative factor, contributing to post-surgical complications. Although surgical enhancement of sufficient buccal peri-implant keratinised mucosa (PIKM) is commonly performed with autogenous grafts, the approach poses various disadvantages. In order to reduce the drawbacks of autogenous graft harvesting, a novel porcine dermal matrix (XDM, mucoderm®) using a modified surgical technique for augmentation of peri-implant keratinised mucosa width is investigated.

AIM

The present prospective case series aimed to evaluate the efficacy of mucoderm® to widen the band of the buccal keratinised mucosa at 6- and 12-month observation periods by comparing the upper and lower jaws. In addition, it was aimed to provide a detailed description of the surgical procedures we developed.

METHODS

In this study, 24 patients with less than 2mm width of peri-implant keratinised mucosa  in the upper and lower jaw were examined. A split thickness flap was created prior to trimming and rehydrating of mucoderm®. Then, the dermal matrix was  positioned and tight contact between periosteum and graft  was ensured using deep periosteal internal horizontal mattress sutures. Patients were followed up at 1 and 2 weeks, as well as 6 and 12 months post-surgery for suture removal, plaque control, and healing assessment. Changes in peri-implant keratinised mucosa width and graft remodelling dimensions were assessed at 6 and 12 months after surgery, with implants being placed between the 6- and 12-month visits based on individual requirements.

RESULTS

The mean peri-implant keratinised mucosa width changed from 0.42 ± 0.47 to 3.17 ± 1.21 mm at 6 months and to 2.36 ± 1.34 mm at 12 months in the maxilla. On the other hand, in the mandible the change was from 0.29 ± 0.45 mm to 1.58 ± 1.44 mm at 6 months and to 1.08 ± 1.07 mm at 12 months. Graft dimensions decreased by 67.7 ± 11.8% and 81.6 ± 16.6% at 6 months, and continued to 75.9 ± 13.9% and 87.4 ± 12.3% at 12 months, in the maxilla and mandible, respectively.

CONCLUSIONS

The present technique using mucoderm® was safe and successfully reconstructed peri-implant keratinised mucosa width in both arches. mucoderm® alone seems to be a suitable alternative to autograft for peri-implant keratinised mucosa width augmentation in the maxilla.

Baseline 12M P
Maxilla 0.42±0.47mm 2.36±1.34mm 0.000035
Mandible 0.29±0.45mm 1.08±1.07mm 0.023

Results of mean peri-implant keratinised mucosa width, significant gain in the maxilla.

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