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Systematic review and meta-analysis

Significantly lower patient morbidity for xenogeneic collagen matrix

Are xenogeneic matrices valuable alternatives to autologous soft tissue grafts for increasing mucosal thickness, gaining keratinized mucosa width, and reducing patient morbidity? A collaboration between Spanish and US researchers, led by Dr. Jordi Gargallo-Albiol, answered this question with a systematic review and meta-analysis.1

In the analysis, the researchers included seven randomized clinical trials that compared connective tissue graft and xenogeneic collagen matrices. A total of 218 implant sites (108 in the connective tissue graft group, 110 in the collagen matrix group) with three to 12 months follow-up period, were evaluated.

The results showed no statistically significant difference in terms of mucosal thickness increase and keratinized mucosa width gain. However, postsurgical discomfort, consumption of painkillers, and treatment times (15.46 minutes less) differed significantly in favor of the collagen matrix group.

The authors concluded: “Our results demonstrated that collagen matrix was as effective as connective tissue graft in increasing peri-implant mucosal thickness…and resulted in significantly less surgical chair-time, patient morbidity, and painkiller consumption.”

The key role of soft tissue augmentation

The consensus report from the Osteology Foundation ascertained that soft tissue grafting to increase the width of keratinized tissue around dental implants can provide greater plaque and gingival index reduction when compared to non-augmented sites.2 In addition, marginal bone levels show better stability following application of autogenous grafts.2 Also, soft tissue grafting to increase the mucosal thickness around implants in the aesthetic zone was associated with significantly less marginal bone loss over time.2 Several materials have been proposed to increase the peri-implant mucosal thickness, including connective tissue grafts,3 allogenic and xenogeneic grafts,4,5 and platelet-rich fibrin.6

  1. Gargallo-Albiol J, et al. Int J Oral Maxillofac Implants. 2019;34(5):1059-1069 (Systematic Review and Meta-Analysis)
  2. Giannobile WV, et al. Clin Oral Implants Res. 2018;29 Suppl 15:7-10. (Summary consensus report)
  3. Cairo F, et al. J Clin Periodontol. 2017;44(7):769-776. (Clinical study)
  4. Park JB. Implant Dent. 2006 Sep;15(3):275-81. (Clinical study)
  5. Thoma DS, et al. J Clin Periodontol. 2016;43(10):874-85. (Clinical study)
  6. Hehn J, et al. Int J Implant Dent. 2016;2(1):13. (Clinical study)

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