Equine collagen to recreate gingival architecture around aesthetic implants

One of the most important problems in aesthetic implantology is to re-create the original aspect of gingivas both in vertical direction and in thickness. This is actually true in all those cases in which single implants have been inserted to replace agenesic teeth or in fresh extration sockets, especially when an immediate loading has been applied. OBJECTIVE: We have evaluated ten cases of anterior implants replacing incisors. They had been referred for periodontal and prosthetic analysis because of the lost of aesthetics in the buccal aspect of the gum; aim of this case study is to verify the efficacy of a technique using sterile equine collagen to increase buccal gingival thickness around single aesthetic implants without using bone grafts or harvesting palatal connective tissue. METHODS: partial thickness flaps have been incised in the buccal aspect of gingiva around upper incisor implants. We have used sterile lyophilized equine collagen sponges directly in the grafted sites in order to improve the aesthetic thickness, "washboard-like", by suturing them to the periostium. A number from 3 to 5 tiles of sponge has been fixed using 6-0 resorbable sutures (Monosyn ,Aesculap). Healing and tissue maturing were monitored after 2 weeks, 1 month, 4 months, 1 year. Rise of thickness has been measured by the same operator in all ten cases using two perpendicular periodontal probes. RESULTS: three weeks after surgery was evident a sensible increase of gum width with a good aesthetic improvement. Six weeks after the improvement was even more sensible. Four months after, a histologic sample showed connectival augmentation in both two sites.CONCLUSIONS: this technique allows an optimal and fast aesthetic gingival reconstruction without morbidity of a donor site and without post-surgical complications.