Peri-implant soft tissue thickening

  • Flap mobilization and soft tissue augmentation
  • Augmentation around the healing cap
  • Tension-free wound closure
  • Well-shaped emergence profile for final prosthetic restoration
Peri-implant soft tissue thickening is a method used to restore lost tissue volumes that are caused by extensive bone resorption or by diseases such as peri-implantitis. In particular, thin biotypes are predisposed to mucosal recessions after implant placement; therefore, preoperative evaluation of the existing bone volume and the surrounding soft tissue health are crucial [1,2]. Depending on the individual clinical situation, which can be classified according to Pallaci and Ericsson [3,4], soft tissue thickening can be performed prior, simultaneously to implant placement or during a secondary surgery to improve the clinical result. A well-balanced soft tissue is characterized by a specific contour, surface structure, and color comparable to that of the surrounding healthy gingiva [5]. In addition, the quantity of the soft tissue, which protects the underlying alveolar bone and increase the resistance against plaque-induced tissue damage, is a parameter that should not be undervalued [6,7]. Similarly, to the autologous tissue, mucoderm® can be applied using all well-established periodontal flap techniques with the benefit to reduce chair time as well as patient´s discomfort and pain.

Rehydration

Prior to application mucoderm® should be rehydrated in sterile saline solution or for few minutes in blood to ensure its flexibility

Trimming

Following rehydration mucoderm® can be easily cut to the specific size and shape of the defect. For horizontal soft tissue augmentation mucoderm® can be centrally perforated and easily placed as a "poncho" over the healing cap.

Suturing

All known periodontal suturing techniques can be applied to fix the matrix tension-free.

After-care

After surgery the treated site must be prevented from any mechanical damage. Patients should be advised not to brush their teeth at the respective side for about 4 weeks. Plaque prevention may be achieved by mouth rinsing with 0.2% chlorhexidine solution.

mucoderm® for peri-implant soft tissue augmentation
mucoderm® für die peri-implantäre Weichgewebsverdickung - Dr. A. Puisys

mucoderm® is a natural collagen scaffold with a native tissue structure that can be used to horizontally and/or vertically augment lost soft tissue volumes also in combination with GBR/GTR. After 5–20 minute rehydration in sterile saline or patient´s own blood, the matrix maintains its volumetric stability and becomes sufficiently flexible to be cut into shape. Due to its homogenous structure, mucoderm® can be applied from both sides. The matrix should be covered by vital tissue (flap) to allow its revitalization trough invading cells and blood vessels. In case of a horizontal soft tissue augmentation around an implant, mucoderm® can be prepared as a “poncho-like” matrix to cover the abutment. Prevention of tension when closing the flap is always of particular importance to facilitate uneventful healing, including mucoderm® integration into the patient´s own connective tissue and the avoidance of fast bacterial resorption.

[1] George and Dhir. J Int Clin Dent Res Organ 2015; 7 (1):119-31
[2] Balasubramaniam et al. Dent Res J 2013; 10:7-14
[3] Palacci and Ericsson. Oral Maxillofac Surg Clin North Am 8, 1996, 445–452
[4] Dattani and Rai. IOSR-JDMS. 2016; 15(1): 54-60
[5] Palacci and Nowzari. Periodontol 2000. 2008; 47: 113-32
[6] Kan et al. J Periodontol. 2003; 74(4): 557-62
[7] Abibrad et al. J Oral Implantol 2009; 35(5): 232-7