Histology and surface ultrastructure during early healing after gingival augmentation with a three-dimensional collagen matrix: A report of six cases.
OBJECTIVE
The objective of the present case series is to describe the histology and surface ultrastructure of augmented keratinized gingival mucosa in humans during the early healing phase after surgical placement of a xenogeneic collagen matrix.


METHODS
Six patients underwent surgical augmentation of keratinized tissue by placement of a three-dimensional (3D) xenogeneic collagen matrix. Full-depth mucosal biopsies including original attached gingiva, augmented gingiva, and the separation zone were performed at baseline and at postoperative days 7 and 14. The specimens were stained with hematoxylin-eosin, Masson-trichrome, picrosirius red, and Papanicolaou's trichrome. Low-vacuum scanning electron microscopy (SEM) surface analysis was correlated with histology.


RESULTS
The separation zone was clearly visible upon histologic and SEM examination at 7 days. The portions of augmented mucosa consisted of well-structured, immature gingival tissue with characteristics of per secundam healing underlying a completely detached amorphous collagenous membrane-like structure of approximately 100 μm thick. At 14 days, histologic and ultrastructural examinations showed an almost complete maturation process. There were no detectable remnants of the collagen matrix within the newly formed tissues at either time point.


CONCLUSIONS
Within their limits the results suggest that the 3D collagen matrix appears to play an indirect role during the early phase of wound healing by protecting the newly formed underlying tissue and guiding the epithelialization process.
Darian
D
Rusu
Stefan-Ioan
SI
Stratul
Dana
D
Festila
Petra
P
Surlin
Adrian
A
Kasaj
Flavia
F
Baderca
Marius
M
Boariu
Holger
H
Jentsch
Cosmin
C
Locovei
Bogdan
B
Calenic
D020341:Absorbable Implants; D000328:Adult; D001706:Biopsy; D003094:Collagen / Q000627:therapeutic use*; D005260:Female; D005893:Gingivoplasty / Q000379:methods*; D006801:Humans; D008297:Male; D008855:Microscopy, Electron, Scanning; D010865:Pilot Projects; D016896:Treatment Outcome; D014945:Wound Healing
D003094:Collagen