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Objective: To clinically and histologically evaluate the potential effect of a cross-linked, high molecular weight hyaluronic acid (xHyA) on the outcomes of guided bone regeneration performed with a demineralized bovine bone mineral (DBBM) covered with a natural collagen membrane. Method and materials: Eleven patients (eight females and three males, mean age53years) with a total of 27 surgical sites were treated. Treatments were performed with either DBBM and natural collagen membrane fixed with tacks (group A) or DBBM mixed with xHyAand subsequently covered with natural collagen membrane (group B). Clinical evaluations were made at baseline (Tl), immediately after guided bone regeneration (T2), and at the time of implant placement (T3). Additionally, at the time of implant placement, core biopsies were retrieved and submitted for histologic analysis. Results: Healing was uneventful in all cases. At 6months, group B revealed a statistically significantly higher crestal ridge dimension compared to group A (P =.007). The histologic analysis revealed a tendency for greater mineralized tissue formation in group B compared to group A (67.5% versus 41.6%) and contained a higher amount of new bone (37.2%) and less DBBM residues (20.9%) than group A (12.8% new bone and 28.8% DBBM residues, respectively). Conclusions: Within their limits, the present data indicate that, during guided bone regeneration with natural collagen membrane, the combination of DBBM and xHyA may improve the qualityand quantityof boneformed with DBBM alone. [ABSTRACT FROM AUTHOR]

Autogenous soft tissue grafting is a commonly performed procedure in periodontal and implant surgery. Reharvesting a connective tissue graft (CTG) from the same palatal donor site is often required, but little is known about the volumetric changes that occur after harvesting a free gingival graft and how long the palatal mucosa takes to regain its original form and thickness. This study evaluated the volumetric changes that occur at the palatal donor site after harvesting a soft tissue graft with a noninvasive digital technology. Nineteen patients needing a CTG for a single site were enrolled. Intraoral digital scans of the palatal donor sites were obtained at baseline and at 1, 3, 6, and 12 months. The digital scans were imported and analyzed with an imaging software to evaluate volumetric changes. Average volume losses of 5.82 ± 2.63 mm³ and 11.03 ± 5.47 mm3 were observed after 1 and 3 months, respectively. Only minor changes were observed at 6 and 12 months. Linear dimensional changes at 5 and 7 mm from the gingival margin were substantially higher than the changes at 3 mm for the 1- and 3-month interval comparisons compared to baseline. Graft dimension was associated with volume loss at 1 and 3 months (P < .01). After palatal harvesting, the donor site undergoes volumetric changes, mostly during the first 3 months, and is attenuated thereafter. [ABSTRACT FROM AUTHOR]

The aim of this retrospective case control study was to compare a porcine collagen matrix (Mucograft Seal, Geistlich) with a free gingival punch graft with respect to size, invagination, and color of resulting soft tissue scar formation. Following definition of inclusion and exclusion criteria, 22 patients were retrospectively included in this study. The patients were divided into two groups. In group A, the extraction socket was filled with bovine bone mineral (Bio-Oss, Geistlich) and covered with a free gingival punch graft. In group B, the extraction socket was filled with bovine bone mineral (Bio-Oss) and covered with porcine collagen matrix. After final prosthetic reconstruction (18 implant-retained crowns and 4 fixed partial dentures), two independent examiners evaluated the size, invagination, and color of the soft tissue scar using a modified scar-evaluation scale originally developed for dermal wounds (lower values correspond to less scarring). Patient satisfaction was recorded using a questionnaire. Patient records were screened for frequency and costs of scar removal treatment. The average scar score for groups A and B was 1.33 and 4.3, respectively, revealing significantly less scarring in group B (P = .000295). Frequency and costs of scar removal treatment were statistically significantly higher in Group A (P = .000234). Patient satisfaction was not statistically significantly different between the treatment groups (P = .711 for group A and P = .809 for group B. The results suggest that alveolar ridge preservation using bovine bone mineral and porcine collagen matrix leads to less scar tissue formation when compared with bovine bone mineral and free gingival punch grafts from the palate. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the relationship between gingival phenotype and tooth location based on selected index teeth ("Ramfjord") and assess possible differences between women and men. Material and Methods: Thirty‐six women and 20 men voluntarily participated in this investigation with an average age of 23 years (min: 19; max: 37). Gingival phenotypes (GP) were assessed by transparency of a periodontal probe through the buccal gingival margin. Results: A comparable and similar GP on all index teeth was only found in seven out of the 56 subjects, that is, thin or thick only: Five participants (three male/two female) showed a uniform and constantly thick and two females a constantly thin GP. While the majority of molars (94.6%; p = 0.006) showed a thick GP, premolars (61.6%; p = 0.09) as well as incisors (70.5%; p = 0.046) were predominantly categorized as thin. In addition, significantly thicker GP was in general observed for maxillary teeth (p = 0.001) but without differences between genders (p = 0.722). Conclusion: No constant GP can be expected within one dentition. The use of the "Ramfjord teeth" may serve as a quick overview and reliable method to screen GP distribution. [ABSTRACT FROM AUTHOR]