Abstract
A short inflammatory phase and fast ingrowth of blood vessels and mesenchymal cells are essential for tissue integration of a biomaterial. Macrophages play a key role in this process. We investigated invasion of macrophages, blood vessels, and proliferating cells into a highly porous and volume-stable collagen matrix (VCMX) used for soft tissue augmentation around teeth and dental implants. The biomaterial was implanted in submucosal pouches in the canine maxilla, and the tissue response was analyzed at six different time points. Immunohistochemistry was done for proliferating cells (PCNA), macrophages (MAC387), multinucleated giant cells (CD86), and blood vessels (TGM2). Blood rapidly filled the VCMX pores. During the first week, MAC387+ cells populated the VCMX pores, blood vessels and PCNA+ cells invaded the VCMX, and CD86+ scattered cells were observed. At 15 days, MAC387+ cells were scanty, blood vessels had completely invaded the VCMX, the number of proliferating cells peaked, and fibroblasts appeared. At 30 days, MAC387+ were absent, the numbers of proliferating and CD86+ cells had declined, while blood vessel and fibroblast numbers were high. At 90 days, residual VCMX was well-integrated in soft connective tissue. In conclusion, the VCMX elicited a short inflammatory phase followed by rapid tissue integration.
Highlights
Biomaterials are widely used in the dental field to overcome the drawbacks of autogenous tissue transplantation
The paraffin histology showed the presence of the volume-stable collagen matrix (VCMX) close to the bone surface along the maxillary alveolar process at all healing periods (Figure 1A)
The present study has shown that MAC387+ and
Summary
Biomaterials are widely used in the dental field to overcome the drawbacks of autogenous tissue transplantation. Lack of an appropriate periodontal or peri-implant soft tissue width and thickness can compromise esthetics, function, or survival of teeth and dental implants [1,2]. Increase of soft tissue thickness is a proven strategy to increase keratinized tissues [3,4], quality of mucosa around teeth [1]. Autogenous connective tissue grafts are used to correct oral tissue deficiencies [8] and still remain the gold standard for soft tissue augmentation due to the good maintenance of volume and lack of adverse effects. Autogenous grafts always require a donor site, causing morbidity and possible damage of neighboring anatomical structures [9].
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