The clinical efficacy of DynaMatrix extracellular membrane in augmenting keratinized tissue.

This study was conducted to compare the efficacy and feasibility of an extracellular matrix membrane (DynaMatrix) with that of an autogenous gingival graft in increasing the width of attached keratinized tissue. Six patients with an inadequate amount of attached keratinized gingiva on the bilateral facial aspect of the mandibular posterior teeth were recruited for this study. The defect sites were randomly subjected to receive either test (DynaMatrix membrane) or control (autogenous gingival graft) treatment. Both test and control sites achieved a clinically significant increase in the amount of keratinized gingiva, and the DynaMatrix membrane-treated sites blended well with the surrounding tissue, with a better appearance when compared to the autogenous gingival grafted sites. The biopsy specimens of both test and control sites appeared to be similar histologically, with mature connective tissue covered by keratinized epithelium. The results of both clinical and histologic evaluations have suggested a potential application of an extracellular matrix membrane in achieving gingival augmentation.

Minimally invasive alveolar ridge augmentation procedure (tunneling technique) using rhPDGF-BB in combination with three matrices: a case series.

This study investigated a minimally invasive surgical procedure for alveolar ridge augmentation that combined recombinant human platelet-derived growth factor BB (rhPDGF-BB) and three different matrices. The minimally invasive tunneling ridge augmentation procedure was applied to 12 patients randomized into three groups: rhPDGF-BB (0.3 mg/mL) was combined with freeze-dried bone allograft (FDBA; group A), anorganic bovine bone graft (ABBG; group B), or anorganic bovine bone graft/mineralized collagen bone substitute (ABBG/MCBS; group C). Computed tomography (CT) scans were obtained presurgically and prior to 14-week re-entry surgery. Clinical reentry revealed adequate bone volume to place implants in all patients in groups A and B and two of four patients in group C. Trephine core biopsies were obtained and evaluated by microCT, backscatter scanning electron microscopy (BE-SEM), and light microscopy. New bone formation was consistently observed with BE-SEM and histologic analysis for group A and B specimens. Newly formed woven and lamellar bone were in close contact with graft particles. The ABBG/MCBS specimens (group C) had more variable results, with fibrous encapsulation of graft particles and limited histologic evidence of new bone formation. Within the limits of this study, the FDBA and ABBG carriers appear to be appropriate scaffolds to deliver rhPDGF-BB for ridge augmentation via minimally invasive surgical techniques.

Human histologic evaluation of mineralized collagen bone substitute and recombinant platelet-derived growth factor-BB to create bone for implant placement in extraction socket defects at 4 and 6 months: a case series.

The objective of this pilot study was to assess whether mineralized collagen bone substitute (MCBS) combined with recombinant human platelet-derived growth factor-BB (0.3 mg/mL) would generate adequate viable bone in buccal wall extraction defects to accommodate implant placement. The primary outcome variable was bone quality, as measured by microcomputed tomography and histologic evaluation. This was successfully accomplished in all eight specimens obtained from seven patients. The secondary outcome variables were bone quality and quantity as observed clinically, radiographically, and by the primary stability of implants at the time of placement. Soft tissue healing was excellent, and there were no unanticipated adverse events. Robust bone formation accompanied by MCBS resorption was evident in all 4- and 6-month specimens. This was accomplished without barrier membranes.