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Background and objectives: The collagen matrices are widely used for regeneration procedures alone or in combination with other dental regeneration materials. The aim of this work was to evaluate the soft tissue healing with acellular dermal collagen matrix (ADCM) being used in various defects. Materials and Methods: The ADCM - mucoderm® was used in peri-implant soft tissue augmentation, hard and soft tissue management in immediate restoration and sealing of extraction socket. For that reason, five patients were retrospectively analysed. Results: The collagen matrix underwent active remodelling into new soft tissue and successful soft tissue healing was observed. Conclusion: The use of mucoderm® led to successful soft tissue treatment in various defects.

After tooth extraction, a modeling and remodeling phase of bone and soft tissues occurs. It has been fully demonstrated that bone resorption as high as 50% can take place regarding ridge width and a variable amount concerning ridge height, making it difficult to perform implant surgery.Active members of the Italian Academy of Osseointegration (IAO) participated in this Consensus Conference, and three systematic reviews were conducted before the meeting to provide guidelines on alveolar ridge preservation procedures. The systematic reviews covered the following topics: (1) What material best preserves the dimensions of the ridge horizontally and vertically?; (2) what material favors the formation of the highest quantity of new bone?; (3) which technique would best seal the socket?; and (4) what effect does alveolar ridge preservation have on soft tissues?The main conclusions reached by the assembly were that alveolar ridge preservation is advisable after dental extraction, particularly in esthetic areas, in proximity of anatomical structures (ie, maxillary sinus, inferior alveolar nerve, and mental foramen), whenever the treatment plan requires delayed placement, and whenever patients ask to postpone implant insertion for various reasons. Socket debridement is advised before the use of a "regenerative material," and xenograft is considered the gold standard material to maintain ridge dimensions. Another indication is antibiotic therapy, which is recommended in the case of alveolar ridge preservation (amoxicillin 2 g 1 hour before the intervention and 1 g every 12 hours for 6 days). A membrane or autologous soft tissue should be used to seal the socket and protect the regenerative material, and the indicated reentry time (implant insertion) is 4 to 6 months.This Consensus Conference agreed that the adoption of alveolar ridge preservation can effectively prevent physiologic bone loss, especially in esthetic areas. It is recommended to cover the xenograft material with a membrane or autologous soft tissue, and antibiotic therapy is advisable.

Keratinized tissue around implants is beneficial for soft tissue stability and esthetics. The aim of this investigation is to show the use of amnion/chorion membrane to increase the keratinized tissue. Fifteen patients were grafted with the allograft at the first or second stage of implant surgery. The mean values of keratinized tissue were 1.27 ± 0.46 mm, 2.00 ± 0.38 mm, 2.80 ± 0.78 mm, and 3.27 ± 0.80 mm at the initial evaluation and 7, 15, and 60 days postsurgery (prosthetic delivery was at day 60), respectively (P < .001). Most increase occurred between 7 days up to the prosthetic delivery. Use of the amnion/chorion membrane seems to improve keratinized-tissue expansion.

This study aimed at a histologic and histomorphometric analysis of the periimplant tissues and bone-titanium interface reactions in successfully osseointegrated, clinically stable, and immobile human titanium dental implants retrieved after a long loading period.In the last 30 months (2013-2015), 21 implants, retrieved from individuals for different causes after a loading period ranging from 4 to 20 years, were sent to the Implant Retrieval Center, University of Chieti-Pescara, Italy. In 4 cases, almost all the bone had been lost during the retrieval, whereas in the remaining 17 cases, mineralized bone was still present.Around the majority of the implants, mature compact bone with few marrow spaces was found. The trabecular bone, constituted by a few thin bone trabeculae, was in a periimplant location around only a few implants. A high percentage of bone-implant contact (BIC) (comprised between 32 ± 4.1% and 83 ± 2.9%) was present. In almost all implants, the space within the threads was almost completely filled by compact lamellar bone or by a thin layer of bone. Close and tight contact between bone and implant surface was observed in all specimens with no gaps or connective tissue at the interface.All implants appeared to be well integrated in the surrounding mineralized bone, and all of them showed adequate bone-to-implant contact percentages.

Only rarely, it is possible to find in the literature histological reports of human retrieved implants, especially after several years of functional loading. These implants can help us in understanding the reactions of peri-implant bone. The aim of this study was to perform a histologic and histomorphometric analysis of the peri-implant tissues behavior and of the bone–titanium interface in titanium dental implants retrieved from patients after time periods longer than 5 years. The archives of the Implant Retrieval Center of the Dental School of the University of Chieti-Pescara, Italy were searched for human dental implants, retrieved after a loading period of more than 5 years. A total of 8 implants were found: 3 of these had been retrieved after 5 years, 1 after 6 years, one after 10 years, 1 after 14 years, 1 after 18 years, 1 after 22 years. Only the bone to implant contact in the three best threads was evaluated. Compact, mature, lamellar bone, with few and small marrow spaces, was present around the implants. Osteons with Haversian canals were present inside some threads, in close proximity to the interface, at both cortical and trabecular regions. Other osteons had a direction perpendicular to the direction of the long axis of the implants. Numerous reversal lines were present. At higher magnification, no gaps or fibrous, connective tissues were present at the interface. The BIC of the three best threads for all implants varied from 94 to 100 %.In conclusion, within the limitations of the present report histology showed that implants with different surfaces all presented the potential to maintain osseointegration over a long period, with a continuous remodeling at the interface, as indicated by the presence of reversal lines.