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Histologic composition of marginal mucosal tissue augmented by a resorbable volume-stable collagen matrix in soft tissue thickening procedures in humans: a morphometric observational study

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Abstract

Aim

This study aims to examine the composition of lining and masticatory mucosa at the pre- and post-soft tissue augmentation procedures with a volume-stable cross-linking collagen matrix (VCMX) in humans.

Materials and methods

In 12 patients, single implant sites were augmented with a VCMX. Biopsies were obtained including masticatory (MM) and lining (LM) mucosa before augmentation and at 12 weeks post-augmentation procedures. Rete pegs density (RPD), length (RPL), and blood vessel density (BVD) were histomorphometrically analyzed at both time points. Picrosirius red staining under polarized light microscopy was used to evaluate collagen fiber organization. The effects of time and tissue type were evaluated by ANOVA with repeated measures.

Results

Both MM and LM areas demonstrated an increase in mean RPL following augmentation, 382.6 µm ± 95.1 vs. 290.5 µm ± 79.3 and 335.6 µm ± 94.2 vs. 292.9 µm ± 77.0, respectively (p < .05). There was a significant difference in the numbers of RP per 1 mm length (RPD) between the MM (9.2 ± 1.7) and LM (6.1 ± 2.8) mucosa but not between the pre- and post-VCMX augmentation time points. The mean BVD in the LM was greater than in the MM (5.5 ± 2.4 and 6.3 ± 2.4 vs. 3.4 ± 3.3 and 3.7 ± 1.8, respectively, p < .05) but not between time points. The collagen fiber arrangements pre- and post-augmentation were not significantly different.

Conclusion

Augmentation with VCMX did not alter the composition of lining and masticatory mucosa at implant sites.

Clinical relevance

A thick soft tissue phenotype around the implant neck is an important factor to maintain peri-implant health. A non-autogenous cross-linking collagen matrix is proposed as an alternate graft substitute in soft tissue augmentation procedures in order to improve implant soft tissue phenotype.

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Funding

The work was supported partially by Geistlich Pharma AG, Wolhusen, Switzerland.

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Author notes

  1. Zvi Artzi and Uri Renert contributed equally to this work.

Authors and Affiliations

  1. Department of Periodontology and Oral Implantology, School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel

    Zvi Artzi, Uri Renert & Erez Netanely

  2. Clinic of Reconstructive Dentistry, University of Zurich, Plattenstrasse 11, CH-8032, Zurich, Switzerland

    Daniel S. Thoma

  3. Department of Oral Pathology and Oral Medicine, School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel

    Marilena Vered

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  1. Zvi Artzi
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  2. Uri Renert
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Contributions

Zvi Artzi: concept/design and investigation (lead); project administration (lead); methodology (equal); project administration (lead); data analysis/interpretation, writing—original draft, drafting article, critical revision of article, approval of article, statistics, data collection, and validation (equal); and resources (equal).

Uri Renert: concept/design and investigation (lead); project administration (lead); methodology (equal); project administration (lead); data analysis/interpretation, writing—original draft, drafting article, critical revision of article, approval of article, statistics, data collection, and validation (equal); and resources (equal)

Erez Netanely: concept/design and methodology (equal); data analysis/interpretation, critical revision of article, approval of article, data collection, and validation (equal); and resources (equal)

Daniel S. Thoma: concept/design and investigation (equal); validation (equal); methodology (equal); writing—review and editing (equal); and resources (equal)

Marilena Vered: concept/design and methodology (equal); data analysis/interpretation critical revision of article, approval of article, data collection, and supervision (equal); validation (equal); and resources (equal)

Corresponding author

Correspondence to Zvi Artzi.

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Ethics approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.. This study was approved by the Tel Aviv University ethics committee (approval no. 134.18). Enclosed separately the original confirmation dated January 08, 2019.

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Informed consent was obtained from all individual participants included in the study.

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The authors declare no competing interests.

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Artzi, Z., Renert, U., Netanely, E. et al. Histologic composition of marginal mucosal tissue augmented by a resorbable volume-stable collagen matrix in soft tissue thickening procedures in humans: a morphometric observational study. Clin Oral Invest 26, 427–435 (2022). https://doi.org/10.1007/s00784-021-04016-1

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