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Soft tissue management

5 questions to Martina Stefanini

25.09.2018
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Where do we stand for soft tissue management? During the last EuroPerio in Amsterdam, Dr. Martina Stefanini shared with us her thoughts and experiences.

Dr. Giulia Cerino | Switzerland

The spotlight is more and more on soft tissue. Does tissue management have an impact on peri-implant health or is it just a question of esthetics?

Dr. Stefanini: For sure, the importance of soft tissue around implants is linked to esthetic factors and to health factors of peri-implant soft tissues. In the anterior area, esthetic factors play a major role and rather than the keratinized tissue (KT), it is important to increase the thickness of soft tissue to prevent recurrence of recession or the transparency of the tissue. In the posterior area, instead, it is more important to increase the amount of KT to improve the potential and the maintenance of the long-term patient home hygiene.

Together with Prof. Zucchelli, you were part of the pre-launch phase of Geistlich Fibro-Gide®. What was the first impression when you had the matrix in your hands?

Dr. Stefanini: The first time I handled Geistlich Fibro-Gide® I realized that Geistlich had reached one of the most important goals in regenerative dentistry: developing a matrix with the capability to maintain the original thickness also when compressed. This is a fundamental aspect when you use a collagen matrix under a flap and Geistlich Fibro-Gide® assures you that despite the compression of the flap above the material, the matrix is able to regain the original thickness and incorporate the blood clot. So far, we treated 10 cases with Geistlich Fibro-Gide® for single recession coverage and we obtained optimal results in terms of root coverage as well as for soft tissue thickness increase.

Based on your experience, what would you recommend to a dentist who wants to use Geistlich Fibro-Gide® in recession coverage?

Dr. Stefanini: I would recommend to follow the indications, which we elaborated together with Geistlich. From my perspective, cutting the matrix for reaching a thickness of 3 mm is the key passage to achieve easier management of the matrix, an easier suture procedure, and to have a faster learning curve.

When would you suggest connective tissue graft (CTG) and when Geistlich Fibro-Gide®?

Dr. Stefanini: I would suggest Geistlich Fibro-Gide® when we have at least 1 mm of apical remaining KT at the recession. Taking this approach, we are sure to cover the root thanks to the coronally advanced flap (CAF) and to increase the soft tissue thickness to prevent the recurrence of the recession in the long-term thanks to the presence of Geistlich Fibro-Gide®. Instead, if we do not have KT but only alveolar mucosa, we still have to use the CTG.

Moreover, in the upper jaw the use of the matrix is always indicated. On the other hand, for the lower incisors, I would still suggest the CTG, which acts as a barrier and recreates the verticality of the vestibule that most of the time is missing in this area.

Nowadays more and more women are graduating in dentistry. Despite this trend, women still remain underrepresented when it comes to opinion leadership, entrepreneurship, and academic careers. Which is your opinion?

Dr. Stefanini: Unfortunately, this is true. Women are still underrepresented when it comes to opinion leadership, entrepreneurship, and academic careers. But I think the trend is changing very quickly. For example, in the university course we have a 50% female presence that increases every year. It is important to have goals to pursue, to be ready to face each other and to take the podium, not because we are women, but because we are good surgeons.

Dr. Giulia Cerino

Dr. Giulia Cerino | Switzerland

Manager Medical Communications
Geistlich Pharma

Photo Header: Nicole Wingenfeld

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