Soft tissue augmentation with xenogenic dermal matrices: when, where and how
Part 1 - Addition of connective tissue graft (CTG) under coronally advanced flap (CAF) is considered as a gold standard in treatment of gingival recession. As a substitute for CTG, different products appeared on the market including animal-origin collagen matrices (CM). Recent systematic reviews estimated double layer collagen matrices with changed collagen structure as a viable alternative to CTG in treatment of isolated/multiple Miller class I or II (Cairo RT I) gingival recessions. In our split-mouth study, porcine dermal matrix (DM) with preserved natural collagen structure was compared to CAF + CTG. The lecture will explain indications, handling and results that we may expect after DM used in conjunction with CAF as alternative to CTG. The usage of DM will be put in the wider framework of available recession coverage techniques as one of the strategies for reducing problems associated with soft tissue harvesting from the palate.
Part 2 - Mucogingival therapy responds fully to an increasingly pressing aesthetic demand, both in dental element and in perio-prosthetic-implant cases. The key clinical parameter for soft tissue evaluation is the absolute absence of inflammation and the complete healing of any pre-existing injury following natural teeth extraction or different traumatic events. Mucogingival and reconstructive implant techniques require surgical skill and new technology expertise, including innovative materials. A correct diagnosis is therefore crucial followed by adequate surgical and material selection. The use of heterologous matrices offers new therapeutic possibilities, with no technique predictability reduction. Of all the prognostic factors predicting success, the behavior of hard and soft tissues is particularly relevant. The flap designs and suturing techniques are described step by step using tutorial videos and schematic drawings.