Mucosal Height Research Articles

Porcine Cross-Linked Collagen Matrix for Peri-Implant Vertical Soft Tissue Augmentation: A Randomized Prospective Observational Study.

The mucosa height has always been of interest in modern implant dentistry to obtain biomimetic results. Papilla height, mucosa scalloping, and free mucosal margin level are crucial to achieve "pink aesthetics". The aim of this study was to investigate the vertical increase in the peri-implant soft tissues with a porcine cross-linked collagen matrix (Geistlich Fibro-Gide®). Methods: A total of 60 patients were divided into the following three groups: Group 1-patients who received porcine cross-linked collagen matrix for vertical soft tissue augmentation and a cover screw combined with a coronally advanced flap (CAF); Group 2-patients who received the collagen matrix combined with a healing abutment and CAF; Group 3 (control group)-patients who received a traditional surgical approach based on crestal incision and no collagen matrix as well as no CAF. Results: The average horizontal tissue thickness growth after 3 months was more effective for Group 1 (1.35 ± 1.23 mm) compared to Group 2 (0.85 ± 0.67 mm) and the control group (0.20 ± 0.41 mm). The average tissue height growth was 1.05 ± 1.39 mm for Group 1, 0.32 ± 1.28 mm for Group 2, and -0.05 ± 0.39 mm for the control group. Finally, the average increase in the band of keratinized mucosa was 0.60 ± 1.23 mm for Group 1, -0.60 ± 0.94 mm for Group 2, and 0.45 ± 0.60 mm for the control group. Conclusions: The combination of the CAF, porcine cross-linked collagen matrix, and cover screw resulted in better clinical results compared to Group 2 and 3.

Association of Peri-Implant Mucosa Dimensions With Emergence Profile Angles of the Implant Prosthesis.

The primary aim of this cross-sectional study was to investigate the association between prosthesis design and peri-implant mucosa dimensions and morphology. The secondary aim was to investigate associations between mucosal dimensions and the presence of mucositis. Forty-seven patients with 103 posterior bone level implants underwent clinical and radiographic examination, including cone beam computer tomography and intraoral optical scanning. Three-dimensional models for each implant and peri-implant mucosa were constructed. Vertical mucosa height (TH), horizontal mucosa width at implant platform (TW), and 1.5 mm coronal of the platform (TW1.5), as well as mucosal emergence angle (MEA),deep angle (DA), and total contour angle (TA) were measured at six sites for each implant. There was a consistent correlation between peri-implant mucosa width and height (β = 0.217, p < 0.001), with the width consistently surpassing height by a factor of 1.4-2.1. All three angles (MEA, DA, TA) were negatively associated with mucosa height (p < 0.001), while DA was negatively associated with mucosa width (TW1.5) (p < 0.001, β = -0.02, 95% CI: -0.03, -0.01). There was a significant negative association between bleeding on probing (BoP) and mucosa width at platform (OR 0.903, 95% CI: 0.818-0.997, p = 0.043) and 1.5 coronal (OR 0.877,95% CI: 0.778-0.989, p = 0.033). Implants with less than half sites positive for BoP (0-2/6) had significantly higher mucosa height (OR 3.51, 95% CI: 1.72-7.14,p = 0.001). Prosthesis design can influence the dimensions of the peri-implant mucosa, with wider emergence profile angles associated with reduced peri-implant mucosa height. In particular, a wider deep angle is associated with reduced mucosa width in posterior sites. Reduced peri-implant mucosa height and width are associated with more signs of inflammation. Registered in Thai Clinical Trials Registry: http://www.thaiclinicaltrials.org/show/TCTR20220204002.

Comparison of three different anastomotic methods of sleeve gastrectomy with transit bipartition using an obese rodent model

The long-term effects and safety of single-anastomosis sleeve ileal (SASI) bypass have not been confirmed. The one anastomosis procedure carries the risk of bile reflux, and Braun anastomosis has the capacity to reduce bile reflux. This study was designed to compare the influences of bile reflux and histological changes in the esogastric sections of rats. Obese Sprague–Dawley rats underwent sleeve gastrectomy with transit bipartition (RYTB) (n = 12), SASI (n = 12), SASI bypass with Braun anastomosis (BTB) (n = 12), esojejunostomy (EJ) (n = 12), and SHAM (n = 8) surgery. During the 12-week follow-up period, weight changes, glucose improvement, and changes in serum nutrition were evaluated. Histological expression and bile acid concentration in the rats in all groups were also evaluated. No significant differences in weight loss and glucose improvements were observed in the RYTB, SASI, and BTB groups. The RYTB and BTB groups had significantly lower bile acid concentration and albumin levels than the SASI group. In addition, mucosal height in the RYTB and BTB groups was significantly lower than in the SASI group. Braun anastomosis had a significant effect on anti-reflux. BTB may be a superior primary procedure due to its potential for parallel bariatric and metabolic improvements, effective anti-reflux effects, simplified operations, and avoidance of severe malnutrition. Further clinical studies are needed to confirm these findings.

Radiographic bone level and soft tissue dimensional changes following explantation of implants affected by peri-implantitis: A retrospective exploratory evaluation.

While the dimensional alteration of alveolar bone following tooth extraction have been extensively descripted in the literature, no information is available regarding potential hard and soft tissues changes following implant explantation. To evaluate the radiographic bone healing and the horizontal and vertical soft tissue dimensional alterations at implant extraction alveoli, 6 months following implant explantation. Data from 31 patients scheduled for extraction of one implant with persisting peri-implantitis despite treatment were analysed. Bone crest level changes and the extent of bone healing at the apical aspect of the implant socket were assessed on the radiographs prior and 6 months following explantation. Regression analyses assessed the impact of various predictors (e.g., bone crest level, presence/absence of buccal bone) on bone level changes. Fisher's exact probability test was applied to assess the difference in probability to have mucosa recession of ≥2 mm in the presence or absence of alveolar buccal bone. A vertical bone loss of 0.8 mm (standard deviation [SD] = 1.3) of the peri-implant bone crest and a gain of 0.8 mm (SD = 1.1) from the bottom of the peri-implant defect were recorded. Complete healing was noted in the intact implant extraction socket (i.e., the part of the implant not affected by peri-implantitis). A reduction of 0.4 mm (SD = 0.7) of the alveolar mucosa height was recorded in concomitant with a decrease of 0.7 mm (SD = 0.8) of the mucosa width. These alterations were more pronounced in the absence of the alveolar buccal bone. The results of the present explorative study indicated a decrease in the height and width of the alveolar soft and hard tissues following explantation of peri-implantitis affected implants, and these changes were more pronounced in the absence of the buccal bone wall. Nevertheless, the apical portion of the implant alveolus (the intact implant socket) tend to heal with no further bone loss.

Fermented Astragalus membranaceus could promote the liver and intestinal health of juvenile tiger grouper (Epinephelus fuscoguttatus).

In order to understand the effects of fermented Astragalus membranaceus (FAM) on the liver and intestinal health of tiger grouper (Epinephelus fuscoguttatus), this study was conducted. This study evaluates the effects of different levels of FAM on liver and intestinal tissue structure, serum biochemical parameters, intestinal digestive enzyme, and microbiota structure of tiger grouper. Fish were fed with diets (crude protein ≥ 48.0%, crude fat ≥ 10.0%) with five levels of FAM (L1:0.25%, L2: 0.5%, L3: 1%, L4: 2% and L5: 4%) in the experimental groups and a regular diet was used as the control (L0: 0%) for 8weeks. Compared with AM, the protein content of FAM was significantly changed by 34.70%, indicating that a large amount of bacterial protein was produced after AM fermentation, and its nutritional value was improved. FAM had significant effects on the growth performance of tiger grouper (p < 0.05). The high-density lipoprotein cholesterol (HDL-C) was highest in L4 group, being significantly different from L0 group. The area and diameter of hepatocytes were lowest in L3 and L4, and the density of hepatocyte was highest in L4 group and relatively decreased in L5 group. The mucosal height and muscular thickness were highest in L3 group. The intestinal microbiota structure of tiger grouper was changed under the intervention of FAM. The lower abundance of potential pathogenic bacteria and higher abundance of probiotics colonization in the L4 group showed that the dose of FAM had the best effect on improving the health of intestinal microbiota. This study indicates that the addition of FAM in the feed contributes to liver health, improves intestinal morphology, and regulates the intestinal microbiota of tiger grouper. The addition ratio of 1%-2% is better for intestinal and liver health, and a high addition ratio will cause liver damage. Our work will provide a reference for the addition and management of FAM in the aquaculture industry.

Volumetric analysis on the use of customized healing abutments with or without connective tissue graft at flapless maxillary immediate implant placement: A randomized clinical trial.

To evaluate buccal volume change after using a customized healing abutment with or without connective tissue grafts (CTG) in flapless maxillary immediate implant placement (IIP). The present study was designed as a randomized clinical trial (RCT). Patients treated with flapless maxillary IIP were allocated into two groups, both receiving a customized healing abutment, and additionally, the test group received a CTG. A cone-beam computerized tomography (CBCT) allowed to access the initial buccal bone thickness (BT). Digital impressions were taken prior to extractions (T0), 1 month (T1), 4 months (T2), and 12 months (T3) after implant insertion and superimposed with computer software allowing to compute variables related to buccal volume variation (BVv) and total volume variation (TVv) (ClinicalTrials.gov: NCT05060055). Thirty-two patients (mean age 48 ± 11 years), sixteen in each group, were evaluated after a 12-month period. After 1 year of treatment, no significant differences were found between groups, although in participants with BT ≤1 mm, control and test groups showed a BVv of -14.18 ± 3.49% and -8.30 ± 3.78%, respectively (p = .033). Regarding mucosa height variation variables, the control group showed approximately the triple vertical recession in both papillae. The placement of a CTG was not capable of completely maintaining the initial peri-implant tissue architecture, although in thin-bone phenotypes, less dimensional changes are expected when a CTG was used.

Cyanoacrylate tissue adhesive vs. conventional sutures in free gingival grafts: a prospective clinical randomized study

Objective: The present prospective randomized clinical study compared the use of Dermabond® tissue adhesive as a substitute for sutures in free gingival graft fixation. Materials and Methods: Twenty individuals with absence of keratinized mucosa (KM) or KM height less than 1.0 mm in the buccal area of the mandibular incisors were selected to receive free gingival grafts. The patients were distributed into two groups: G1, composed of 8 patients with 10-mm grafts fixed with sutures; G2, composed of 10 patients with 10-mm grafts fixed with Dermabond®. All grafts had the same height (5mm) and thickness (1mm). Bleeding on probing, probing depth, gingival recession, keratinized mucosa height, attached keratinized mucosa height, and clinical attachment level were measured at 0, 15, 30, 45, 90, and 180 days. Results: ANOVA test showed significantly smaller graft contraction and significant increase in attached keratinized mucosa (p &lt; 0.05) in G2, compared to G1. Additionally, G2 exhibited significant clinical root coverage (p &lt; 0.05). Conclusions: The free gingival grafts fixed with Dermabond® tissue adhesive presented a faster clinical surgery, better dimensional stability, clinical root coverage, and did not alter the clinical healing process.

Morphometric indicators of the wall of the crop of broiler chickens when using some biologically active feed additives

Purpose: describe the histological structure and morphometric parameters of the crop of broiler chickens and determine the effect of the multienzyme preparation and humic substances on its structure.Materials and methods. The multienzyme preparation contained beta-gluconase, pentosanase, proteolytic, lipolytic, cellulolytic and amylolytic enzymes. Group 1 received the main diet, balanced in all respects. Group 2 received an enzyme preparation 1 g/kg of feed in addition to the main ration. Group 3 received 1 g/kg of sodium humate feed in addition to the main diet. Group 4 received both an enzyme preparation and sodium humate, 1 g/kg of compound feed, in addition to the main diet. Withdrawal from the experiment occurred at 28 and 49 days of age. For research, 5 samples of crop from the group were selected.Results. Studies have shown ongoing processes of growth and differentiation of structures within 49 days of cultivation. The thickness of the crop wall in birds of the control group decreases by 11.8 %, which may be due to an increase in the size of the organ, its fullness and the mechanical effect of the feed components on its wall. The decrease in the thickness of the wall of the crop by 49 days of age occurs mainly due to a decrease in the thickness of the muscular membrane by 38.5 %. The relative mucosal height increases with bird age from 44 % at 4 weeks of age to 53 % at 49 days of age. An increase in the height of the epithelium by 6.4 % is observed, and the thickness of the lamina propria decreases with age. By 49 days of age, in all experimental groups, the muscular coat is significantly larger, and the submucosa is smaller than in the control group. The maximum thickness of the muscular membrane in group 2 is 1.6 times more than in group 1. The relative height of the epithelium is minimal in groups 2 and 3 - 44 %. In these groups, a significantly greater wall thickness was observed than in the control group, mainly due to the muscular layer. Sodium humate does not adversely affect the structure of the crop. Long-term use of the multi-enzyme complex irritates the mucous membrane in the first period of cultivation. This is expressed in an increase in the thickness of the epithelium by 20%. Further, the wall adapts to the irritating effect of the drug, and in the second period of cultivation, no negative effect on the crop mucosa was found in this group. The complex use of additives in the first period of cultivation leads to inhibition of the development of all structures of the mucosa, except for the epithelium. Apparently, the negative effect of the enzyme preparation is affecting. But at the same time, the irritating effect of additives on the mucous membrane is not observed, since the height of the epithelium does not change significantly. Apparently, in this case, we see a positive adaptogenic effect of humic substances on the organ wall. In the second growing period, no negative effect of additives on the crop wall was found.Conclusion. The wall thickness of the crop decreases with age, due to a decrease in the thickness of the muscular membrane. The height of the epithelium in the mucosa increases. Long-term use of sodium humate does not adversely affect the histological structure of the crop. The continuous use of enzyme preparations irritates the mucous membrane of the crop in the first period of cultivation, in the second period of such an effect of the additive is not observed. The combined use of these additives does not irritate the wall of the crop.

Retrospective analysis of keratinized tissue augmentation using a xenogeneic collagen matrix for resolving peri-implant mucositis and peri-implantitis.

The significance of keratinized tissue for peri-implant health has been emphasized. However, there is an absence of clinical evidence for the use of a xenogeneic collagen matrix (XCM) to manage peri-implant mucositis and peri-implantitis. Therefore, the purpose of this study was to investigate outcomes after keratinized tissue augmentation using an XCM for the management of peri-implant diseases. Twelve implants (5 with peri-implant mucositis and 7 with peri-implantitis) in 10 patients were included in this study. Non-surgical treatments were first performed, but inflammation persisted in all implant sites. The implant sites all showed a lack of keratinized mucosa (KM) and vestibular depth (VD). Apically positioned flaps with XCM application were performed. Bone augmentation was simultaneously performed on peri-implantitis sites with an intrabony defect (>3 mm). The following clinical parameters were measured: the probing pocket depth (PPD), modified sulcular bleeding index (mSBI), suppuration (SUP), keratinized mucosal height (KMH), and VD. There were no adverse healing events during the follow-up visits (18±4.6 months). The final KMHs and VDs were 4.34±0.86 mm and 8.0±4.05 mm, respectively, for the sites with peri-implant mucositis and 3.29±0.86 mm and 6.5±1.91 mm, respectively, for the sites with peri-implantitis. Additionally, the PPD and mSBI significantly decreased, and none of the implants presented with SUP. Keratinized tissue augmentation using an XCM for sites with peri-implant mucositis and peri-implantitis was effective for increasing the KMH and VD and decreasing peri-implant inflammation.

Beyond Laryngeal Clefts: Interarytenoid Injection Augmentation to Predict Success of Suture Augmentation in Children.

To assess the efficacy of interarytenoid injection augmentation (IAIA) and the ability of IAIA to predict response to interarytenoid suture augmentation (IASA) based on diet advancement on video fluoroscopic swallow studies (VFSS). Retrospective cohort analysis of patients with persistent pharyngeal dysphagia at a tertiary children's hospital with VFSS pre- and post-IAIA were included between March 2011 and June 2019. Median age of the 229 patients was 2.2 years (5.8 months-19 years). Interarytenoid mucosal height (IAMH) was found to be above the false vocal folds in 112 patients (53.4%) and at true vocal folds in 10 (4.9%) patients. On VFSS post-IAIA, 95 (41.5%) patients were successfully advanced in recommended diet consistency, 115 (50.2%) were stable, and 19 (8.3%) needed thicker consistency. Paired t-tests on pre- and post-operative consistency scores showed significant improvement, p-value of <0.0001, 95% confidence interval (CI; 0.50-0.85). Poisson regression found no covariates with significant association with improvement on IAIA. For IASA patients, 35/60 (58.3%) improved on post-op VFSS. Paired t-tests on pre- and post-operative consistency scores showed significant improvement, p-value of <0.0001, 95% CI (0.63-1.33). Positive predictive value for IAIA predicting response to IASA was 77% with positive likelihood ratio of 2.3. The response to IAIA versus no response to IAIA likelihood ratios were found to have a statistically significant difference (p< 0.05). Our study suggests IAIA yields objective improvement in swallow function on VFSS in nearly half of our patients and may be a reliable diagnostic tool to predict response to IASA in patients with persistent pharyngeal dysphagia with or without a laryngeal cleft. 3 Laryngoscope, 133:1749-1756, 2023.

Long-Term Evaluation of the Lip and Nose in Bilateral Complete Cleft Lip Patients following Lip Adhesion and Secondary Nose Correction.

Background Surgical correction of bilateral cleft lip deformities remains one of the most challenging areas in facial plastic surgery. Many surgical techniques and conservative devices have been offered for the early management of bilateral cleft lip in infants. The purpose of this study was to evaluate the effect of lip adhesion on the lip and nose of patients with bilateral cleft lip. Methods A retrospective review of 13 patients with bilateral cleft lip was performed and compared with age-matched noncleft children. Patients underwent lip adhesion at a mean age of 2.8 months, and cheiloplasty at 6.6 months of age using a modification the Mulliken method. Secondary rhinoplasty was performed at the age of 6 in 13 patients. The surgical results were analyzed using photographic records obtained at the age of 1 and 7 years. Twelve length measurements and one angle measurement were obtained. Results All measurements were not statistically different from those of the noncleft age-matched control group at the age of 1. At 7 years of age, upper lip height and vermilion mucosal height were shorter ( p < 0.05) than in the control group. Nasal tip protrusion and the nasolabial angle were greater ( p < 0.05) than in the control group. Conclusion Lip adhesion followed by secondary rhinoplasty resulted in an acceptable lip and nasal appearance. Although nasoalveolar molding is now widely used, lip adhesion can be an appropriate alternative if an orthodontist is not available due to geographical or economic constraints.

Curcumin ameliorated low dose-Bisphenol A induced gastric toxicity in adult albino rats

Bisphenol A (BPA) is one of the most common worldwide chemicals involved in the industry of polycarbonate plastics, medical devices, and pharmaceuticals. Forty three-month-old albino rats were randomly classified into four groups. Group Ӏ received a daily corn oil dose (5 mL/kg/ body weight, BW) through a gastric tube for one month, Group ӀӀ received a daily dose of Curcumin (200 mg/kg body weight (B.W.) through a gastric tube for one month, Group ӀӀӀ received a daily dose of BPA (0.5 μg/kg B.W.) through a gastric tube for one month and Group ӀV received concomitant daily doses of Bisphenol A and Curcumin as the regimen described in groups ӀӀ and ӀӀӀ. The rats were sacrificed, and glandular portion of stomach was dissected and processed for light, immunohistochemical and ultrastructural study. BPA induced destructed gastric glands, dilated congested blood vessels, submucosal oedema, decreased PAS-positive reactivity, increased collagen fibres deposition, decrease in the positive BCL2 immunoexpression, increased positive PCNA immunoexpression, reduction in the gastric mucosal height and destructive changes in the enteroendocrine, chief and parietal cells. Curcumin coadministration provoked an obvious improvement in the gastric structure. BPA exposure has toxic effects on the glandular portion of the stomach in rats. Otherwise, Curcumin coadministration has exhibited protective impact on the architecture of the stomach.

Unilateral Cleft Lip Repair: Technical Maneuvers to Achieve Vermilion and Mucosal Height.

Background:Patients with unilateral cleft lip often require secondary procedures due to asymmetric fullness or deficiencies along the mucosal free margin of the upper lip. Here, we describe our technique for mucosal advancement and repair to attain symmetry.Methods:Maneuvers to obtain vermilion and mucosal height include (1) use of a tailored vermilion flap; (2) supraperiosteal release of the lesser segment; (3) backcut “poker incision” to mobilize the mucosal flap on the lesser segment; (4) transverse release of mucosa across the greater segment; (5) accurate reduction along vermilion-mucosal junction; and (6) bilateral medial mucosal advancement. To examine postoperative outcomes, photographic data were available for 14 patients with unilateral complete cleft lip. The Cleft Lip Component Symmetry Index was then calculated as a ratio of upper lip height on cleft to noncleft sides, where an index of 1 indicates symmetry.Results:Sixteen consecutive patients underwent unilateral cleft lip repair with this technique over a 3-year period, none of whom have required secondary operations. The symmetry index for 14 of 16 patients was 1.02 ± 0.11 (95% confidence interval [0.96, 1.08], P = 0.56), demonstrating satisfactory upper lip symmetry.Conclusions:Postoperative asymmetry after unilateral cleft lip repair, particularly along the free margin, continues to be a common problem, necessitating secondary procedures. The technique of mucosal repair merits more careful attention than it has previously received, and here we describe in detail a method that has allowed for improved symmetry.

Esthetic complications in implant dentistry.

Esthetic complications in implant dentistry have become a significant consideration for patients and practitioners. This review presents an appraisal on the current knowledge of the physiological peri-implant soft-tissue dimensions and factors that may compromise peri-implant tissue esthetics. Factors such as papilla fill adjacent to the implant and midfacial mucosal height are critical parameters that determine the esthetic success of implant-supported restorations. Papilla fill adjacent to a single dental implant appears to depend upon the clinical attachment level of the neighboring tooth. A horizontal inter-implant distance of at least 3mm is necessary to ensure optimal interproximal mucosal embrasure between two adjacent implants in the anterior maxilla. In cases where implants cannot be placed at least 3mm apart, a single implant with a cantilever bridge should be considered. Buccolingual implant positioning plays a major role in midfacial mucosal height. Soft-tissue volume grafting following immediate implant placement in the presence of a thin soft-tissue phenotype or simultaneous to surgical peri-implantitis therapy might help to overcome facial mucosa recession.

The Protective Effect of Transit Bipartition and Its Modification Against Sleeve Gastrectomy-Related Esophagitis in a Rodent Model.

The protective effect of transit bipartition against esophagitis has not yet been proven. Thus, we investigate and compare the bariatric outcomes and esophagus' histological changes of sleeve gastrectomy (SG), SG with transit bipartition (SG-TB), and the proximal SG-TB (SG-PTB) in a rodent model. This study included 45 diabetic Sprague-Dawley rats assigned to one of the four groups, SG-PTB (n = 15), SG-TB (n = 12), SG (n = 10), and SHAM (n = 8). Eight surviving rats from each group were included for further investigation. Histological analysis of the gastroesophageal junction was performed. Body weight, food intake, glucose control, and hormonal changes (glucagon-like peptide-1 and insulin) were assessed before and after surgery in all groups. Preoperatively, no significant differences were observed in food intake, body weight, and fasting blood glucose levels among the groups. Postoperatively, the SG-PTB and SG-TB groups showed significantly superior glucose control compared to the SG group following the gavage of glucose (p < 0.05). Postoperatively, the SG-PTB and SG-TB groups had higher postoperative GLP-1 levels than postoperative SG and SHAM groups. More severe esophageal hyperpapillomatosis (EHP) of the esophageal section was observed in the SG group. The mucosal height of the SG group was significantly higher than that of the SG-PTB, SG-TB, and SHAM groups (p < 0.05). The transit bipartition procedure may protect the distal esophagus from histological changes associated with esophagitis. Clinical studies are needed to confirm the anti-reflux effects of transit bipartition.

Effect of water deprivation and increasing levels of spineless cactus (Nopalea cochenillifera) cladodes in the diet of growing lambs on intake, growth performance and ruminal and intestinal morphometric changes

We evaluated the effects of total water intake (TWI) deprivation and dietary supplementation with spineless cactus (Nopalea cochenillifera) cladodes on dry matter intake (DMI), average daily gain (ADG), feed conversion ratio and morphometric characteristics of rumen and intestinal tissues of Santa Inês sheep. Forty-two intact male Santa Inês sheep were used, with an average age of 100 ± 3 days and a body weight of 18.74 ± 2.05 kg. The animals were allocated to a completely randomised design in a 3 × 2 + 1 factorial arrangement with additional treatment of the control type, where (3) are cactus diets replacing Tifton-85 hay (30, 50 and 70% on dry matter (DM) basis) and (2) watering regimens (drinking water deprivation or ad libitum access to drinking water). The control treatment (1) contained 0% spineless cactus and had ad libitum access to drinking water). There was no interaction (P > 0.05) between spineless cactus inclusion and water deprivation on sheep performance. Water deprivation reduced (P < 0.001) TWI and increased (P < 0.001) the DMI/TWI ratio. It did not change slaughter body weight, total weight and ADG of sheep (P > 0.05). The spineless cactus inclusion quadratically increased (P ≤ 0.05) the DMI, slaughter body weight, ADG and feed efficiency. Contrary, TWI and DMI/TWI linearly decreased due to spineless cactus inclusion (P ≤ 0.05). Based on the means test, the DMI was higher at 30% inclusion level of cactus and decreased at 50 and 70%. There was no interaction (P > 0.05) between spineless cactus inclusion and drinking water deprivation for rumen papillae length, width and muscle thickness and intestinal mucosal height. The interaction between water and drinking water deprivation demonstrated that intestinal mucosal height (P ≤ 0.05) in the treatment with 50% inclusion was greater for the treatment with drinking water deprivation. A higher weight of the gastrointestinal tract was observed for the cactus substitution levels of 30 and 50%. The inclusion of 30% DM of spineless cactus replacing Tifton grass hay in sheep diet improved DMI, weight gain and feed conversion, regardless of the availability of drinking water. Drinking water deprivation in Santa Inês sheep receiving spineless cactus does not change the length and width of the ruminal papillae. However, sheep receiving spineless cactus increases the height of the intestinal papillae, irrespective of the inclusion level, because liquids facilitate the transportation of gastric contents, resulting in greater nutrient absorption.

Effect of customized healing abutments on the peri-implant linear and volumetric tissue changes at maxillary immediate implant sites: A 1-year prospective randomized clinical trial.

Immediate implant placement (IIP) associated with the use of bone substitutes and collagen matrices (CM) seems to reduce the amount of resorption at peri-implant areas. Recently, customized healing abutments (CA) appeared as another solution in order to seal the socket and preserve the original soft tissue contour. To evaluate peri-implant tissues dimensional changes after using customized healing abutments compared with the use of xenogeneic collagen matrices as socket sealing options in flapless maxillary immediate implant placement. The present study was designed as a prospective, randomized, controlled clinical trial. Patients were allocated into two groups depending on the socket sealing option: in the CM group a collagen matrix was used and in the CA group a customized abutment. Digital impressions were taken prior to extraction, 1, 4, and 12months after implant insertion and the digital files allowed to evaluate linear buccal changes (MBC) and the buccal volumetric variation (BVv) between the different time points at peri-implant tissue areas. Additionally, mucosa variation was computed assessing the papilla presence and the midfacial mucosa height. Statistical significance was set at 0.05. Twenty-eight patients were observed during a 12-month period. Significant differences between mean values of BVv at the first month were observed at the CM and CA group (-9.75 ± 6.65% and -4.76 ± 5.29%, respectively) (p=0.043). At the 1-year follow-up, no significant differences were found in terms of BVv between the two groups, although the thin bone phenotype (≤1 mm) significantly influenced the volumetric variations that occurred in each group. No significant differences were noticed in midfacial mucosa and papillae alteration between groups, after 1 year of treatment. Both treatment options are predictable solutions for socket sealing in IIP, although a higher volumetric variation can be expected in the presence of thin bone phenotypes.

Buccal Pedicle Flap Combined With Porcine Collagen Matrix: A Follow‐Up of 2 Years on 40 Consecutive Cases

A thick peri-implant mucosa is of importance to prevent recession, color alterations, bone remodeling and promote "creeping attachment." A volume stable porcine cross-linked collagen matrix has been recently introduced for soft tissue regeneration and volume maintenance. The aim of this study was to investigate peri-implant soft tissue healing and stability on 40 consecutive patients treated with buccal pedicle flap combined with the use of the collagen matrix. The buccal pedicle flap combined with a volume stable collagen matrix was executed at second stage surgery. The average initial mucosa thickness was 1.32 mm whereas the average band of keratinized mucosa was 1.65 mm and the height 1.3 mm. Four months after surgical procedure and before delivering the final restoration, the peri-implant soft tissue measurements were significantly increased: the average band of keratinized mucosa was 5.10 mm, the mucosa thickness was 3.27 mm, and the mucosa height was 3.32 mm. After 2 years of follow-up, the superimposition of 3D models described an overall volumetric stability of the augmented mucosa with no signs of soft tissue collapse. The proposed modified buccal pedicle flap was demonstrated to perform well in terms of decreased morbidity, maintenance of blood supply, stabilization of the pedicle, superior haemostasis, and speed of treatment. No significant variations of the keratinized tissue were registered when the buccal pedicle flap was executed in conjunction with the collagen matrix that however provided color match with the surrounding tissue as well as an increased mucosa thickness.

Clinical Performance of a Novel Two-Piece Abutment Concept: Results from a Prospective Study with a 1-Year Follow-Up.

Development of a stable and healthy soft-tissue barrier around dental implants is key to long-term success of implant-supported prostheses. The novel two-piece abutment concept shifts the prosthetic interface to the soft-tissue level to protect bone interface/connective tissue during the healing phase and restorative procedures. This prospective study included 72 patients treated with 106 implants to support a single-tooth or a three-unit bridge restored with two-piece abutments. The evaluation included marginal bone level change (MBLC), implant and prosthetic survival, soft-tissue health including keratinized mucosa height and mucosal margin position, patient quality of life (QoL) and satisfaction, and clinician satisfaction and ease-of-use rating of the concept. Mean MBLC from implant placement to 1 year was −0.36 ± 1.26 mm (n = 89), the 1-year implant and prosthetic survival rates were 97.1 and 96.7%, respectively, while keratinized mucosa height increased from 2.9 ± 1.2 mm at prosthetic delivery to 3.2 ± 1.3 mm, and mucosal margin migrated coronally by 0.49 ± 0.61 mm by 1 year. Patient satisfaction and QoL were high. Clinicians were satisfied with the esthetic and functional results and rated the concept as easy to use. In conclusion, the novel two-piece abutment concept promotes good peri-implant tissue health, while providing an easy-to-use workflow and high treatment satisfaction to both patients and clinicians.

The Influence of Abutment Macrodesign on Facial Peri-implant Tissue Dimensions for Guided Placed and Restored Implants at Healed Sites: 1-Year CBCT Findings from a Randomized Controlled Clinical Trial.

This study aimed to evaluate facial peri-implant tissue dimensions for implants connected to either convex or concave final abutments. Patients (n = 28) were randomly allocated to receive a single implant with an abutment of either convex (Group CX) or concave (Group CV) emergence shape. Twelve months after implant placement, CBCT scans were taken and reference points were identified: first visible bone-to-implant contact, implant shoulder (IS), bone crest (BC), and marginal mucosal level (MML). Mucosal thickness was evaluated at the level of IS (MT1), above the level of BC (MT2), and at the mid-distance of BC-MML (MT3). The mean total vertical peri-implant mucosa height was 3.26 ± 0.77 mm for Group CX and 3.70 ± 0.99 mm for Group CV (P = .23). The mean vertical peri-implant mucosa height below the bone crest was 0.62 ± 0.57 mm for Group CX and 1.26 ± 0.95 mm for Group CV (P = .04). Group CV had greater mean MT2 (4.09 ± 0.72 mm vs 3.36 ± 0.81 mm; P = .02) and MT3 (2.81 ± 0.66 mm vs 2.03 ± 0.60 mm; P = .005) compared to Group CX. Abutment macrodesign may have an effect on vertical and horizontal peri-implant tissue dimensions.