08 January 2019

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Use of porcine dermal matrix and a synthetic bone substitute in GBR procedures in an aesthetic field

Piero Papi

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Last November 10th in Berlin, during the "Bone and Tissue Days Congress", the two-year "Straumann-botiss YoungPro Award" for best under 35 researchers in the field of implant biomaterials was awarded to the Italian Piero Papi (research at the Department of Odontostomatological and Maxillo-Facial Sciences, Sapienza University of Rome) for the work "Immediate implant placement and peri-implant augmentation with a porcine derived acellular dermal matrix and synthetic bone in the aesthetic area" conducted at the Policlinico Umberto I, Sapienza University of Rome, under the supervision of Professor Giorgio Pompa, Director of the Department of Oral Surgery, belonging to DAI Testa Collo (Director Professor Antonella Polimeni).
Below is a summary of the Work done by the same author, Dr. Piero Papi.

THE STUDY
In this study, 15 patients were enrolled, with the need for an implant-prosthetic rehabilitation in the aesthetic field. The objectives of the study were to evaluate the results of the use of a three-dimensional dermal matrix of porcine origin and of a synthetic bone substitute in the procedures of guided bone regeneration, contextual to the implant placement.
The patients enrolled had missing central and lateral incisors, with a width and thickness of the keratinized gingiva of less than 2 mm and the loss of gingival convexity due to tooth extraction, which took place during the previous 8 weeks.
The dental implants (Bone Level Tapered Roxolid, Straumann), with a standard or reduced diameter, were positioned and the guided bone regeneration was carried out using a synthetic bone substitute (Maxresorb, botiss biomaterials) to correct the bone defect and restore a correct thickness of the buccal wall and a 3D dermal matrix (Mucoderm, botiss biomaterials) to restore the lost gingival convexity.

Fig. 1 Pre-operative clinical situation of gingival convexity in the absence of a left lateral incisor

Fig. 2 Guided bone regeneration with Maxresorb

Fig. 3 Closure with Mucoderm matrix, left partially exposed

The results at a 1-year follow-up showed an average gain of about 2 mm of the keratinized gingiva around the implants, both in width and in thickness, with an excellent stability of the peri-implant tissues during the observation period. The use of this membrane has made it possible to avoid the picking from the palate of a connective tissue graft, with excellent aesthetic and functional results.

Fig. 4 Postoperative clinical situation at one year of follow-up