Received 03.03.2025
DOI: 10.35556/idr-2025-3(112)62-66
Use of xenograft to change gum thickness in the dental implant area
Chekanova A.A.1, ORCID: 0009-0001-1426-2568
Selsky N.E.2, ORCID: 0000-0001-8693-3482
Musina L.A.2, ORCID: 0000-0003-1237-9284
1 Federal State Budgetary Educational Institution of Higher Education “Urals State Medical University” of the Ministry of Health of the Russian Federation
620028, Russia, Yekaterinburg, Repina St., 3
2 Federal State Budgetary Educational Institution of Higher Education “Bashkir State Medical University”
450008, Russia, Republic of Bashkortostan, Ufa, Lenin St., 3
Summary
Currently, in prosthetics using dental implantation, an increase in the thickness of the gum is widely used by using connective tissue autografts, which are formed from the mucous membrane of the palate or from the tubercle of the upper jaw of the patient.
The main disadvantage of using connective tissue autografts is the presence of an additional second surgical field. In this regard, the problem of finding connective tissue grafts to increase the thickness of the gum, replacing autografts, is relevant.
The aim of this work is to investigate the possibility of using a targeted xenograft to increase the thickness of the gum in the area of a dental implant.
Material and methods. The study included patients of dental clinics in Yekaterinburg (n = 20), who underwent plastic surgery in combination with closure of the wound surface with a xenograft. The growth of keratinized attached gingiva was assessed immediately after surgery and 6 months after surgical treatment using microscopic examinations. The gingival thickness was measured before and after implantation using morphological analysis of the surgical tissues.
Results and discussion. The initial gingival thickness corresponded to the “thin” phenotype and ranged from 0.391 to 0.937 mm. Six months after dental implantation, unsubstituted fibers were detected throughout the xenograft between mature collagen fibers, areas with signs of a developing inflammatory process were determined in the form of the presence of a large number of lymphocytes, macrophages, poorly differentiated cells and single multinucleated cells, which are characteristic of a chronic inflammatory process. The thickness of the formed connective tissue as a result of replacing the transplanted xenograft additionally amounted to only 0.273 to 0.428 mm, which together with the initial thickness of the connective tissue plate of the gingival mucosa amounted to 0.664 to 1.365 mm and corresponded to the “thin” and “medium” gingival phenotypes.
Conclusions. Clinical trials have shown that the use of xenografts contributed to the regeneration of soft gingival tissues, but only slightly increased the thickness of the gum: from 0.391–0.937 mm to 0.664–1.365 mm. Taking into account the obtained results, the use of the studied xenografts for the regeneration of soft gingival tissues in order to increase the thickness of the gum is inappropriate.
Keywords: mucosal biotype, implant, attached gum, xenogenic membrane, keratinized gum.
For citation: Chekanova A.A., Selsky N.E., Musina L.A. Use of xenograft to change gum thickness in the dental implant area. Stomatology for All / Int. Dental Review. 2025; no. 3 (112): 62–66 (in Russian). doi: 10.35556/idr-2025-3(112)62-66
References
1. Gulyaeva O., Averyanov S. Prevention of inflammatory complications after dental implantation. Parodontologiya. 2017; no. 22 (2): 84–88 (in Russian).
2. Lebedenko I.Y., Arutyunov S.D., Ryakhovsky A.N. Orthopedic Dentistry. Vol. 1: national guide: in 2 vol. 2nd ed. revised and supplemented. М.: GEOTAR-Media, 2022; 520 p. (in Russian).
3. Abolmasov N.N., Abolmasov N.G., Abolmasov I.N. Orthopedic stomatology: textbook 12th ed., revision and supplement. M.: GEOTAR-Media, 2024; 564–570 (in Russian).
4. Gabidullina V.R. Influence of surgery volume and antibiotics on the implantation result. Stomatology. 2023; Vol. 102, № 3: 90 p. (in Russian).
5. Kalamkarov A.E. Biomechanical aspects of the occurrence of changes in the alveolar bone during orthopedic treatment of patients with defects of the dental arches using dental intraosseous implants. Stomatology for All / Int. Dental Review. 2014; no. 2 (67): 12–15 (in Russian).
6. Kalamkarov A.E. Experimental-clinical substantiation of application of dental intraosseous implants in orthopedic treatment of patients with complete absence of teeth: Autoref. dis. … doct. med. sciences. Tver, 2016; 45 p. (in Russian).
7. Kostionova-Ovod I.A. Radiological analysis of the structures of the keratinized gingiva and the external cortical plate in the area of intact frontal teeth on the upper jaw: Autoref. dis. …. kand. med. sciences. Samara, 2021; 23 p. (in Russian).
8. Kulakov A.A., Andreeva S.N. The role of clinical recommendations in ensuring the quality of care in dental implantation. Stomatology. 2019; no. 98 (6): 107–111 (in Russian). doi: 10.17116/stomat201998061107
9. Cohen E. Atlas of cosmetic and reconstructive periodontal surgery. Moscow: Practical Medicine, 2011, 416 p.
10. Trunin D.A., Nesterov A.M., Sadykov M.I., Kostio-nova-Ovod I.A. Method of elimination of local gingival recession. Ural Medical Journal. 2019; no. 12 (180): 14–17 (in Russian).
11. Antonova I.N., Orekhova L.Y., Ulitovsky S.B., Yaremenko A.I., Potapchuk A.A. Stomatological health of the nation. SPb: publishing house Man, 2023; 448 p. (in Russian).
12. Chekanova A.A., Selsky N.E., Musina L.A., Shimova M.E. Comparative characteristics of the gingiva remodeling in the projection of the dental implant with the use of the allograft made from the broad fascia of the thigh and the autograft. Problems of Dentistry. 2024; no. 20 (2): 149–155 (in Russian).
13. Chekanova A.A., Selsky N.E., Kovtun O.P., Shimova M.E. Modern aspects and clinical perspectives of changing the biotype of the mucous membrane in the projection of the dental implant (based on a literature review). Stomatology for All/ Int. Dental Review. 2024; no. 3 (108): 46–51 (in Russian). doi: 10.35556/idr-2024-3(108)46-51
14. Araudho M., Bashursky D.D., Baur G.R. et al. Clinical periodontology and dental implantation: Manual in 2 volumes Vol. 1. M.: GEOTAR-Media, 2021; 720 p. (in Russian).