Volumetric stability and patient-reported outcomes after soft-tissue augmentation: A case series.
TL;DR
Peri-implant soft-tissue augmentation with a porcine acellular dermal matrix showed partial volumetric maintenance over 2 years and favorable patient-reported outcomes, which highlight that patients' perceptions and measured tissue changes reflect different aspects of treatment outcomes.
Abstract
Background
The purpose of this study was to evaluate the 2-year volumetric stability and patient-reported outcomes following peri-implant soft-tissue augmentation with a porcine acellular dermal matrix.
Methods
This prospective case series included patients requiring implant-supported rehabilitation with buccal peri-implant soft-tissue deficiency and mucosal thickness <2 mm. A porcine acellular dermal matrix was used for buccal soft-tissue augmentation. Digital intraoral scans were obtained at baseline, immediately after surgery, and at 10 days, 1 month, 3 months, and 24 months. Volumetric variation and mean distance were assessed by three-dimensional scan superimposition. Clinical parameters and patient-reported outcome measures, including visual analog scale (VAS) pain scores, analgesic consumption, and Oral Health Impact Profile-14, were recorded.
Results
Six patients contributing eight implant sites were treated; five patients completed the 24-month follow-up. An early increase in soft-tissue volume was observed immediately after surgery and at 10 days, followed by progressive contraction during healing. At 24 months, the mean volumetric change remained slightly positive, although the mean thickness gain was minimal and inter-site variability was substantial. Clinical parameters remained stable, and patient-reported outcomes indicated limited morbidity and generally favorable oral health-related quality of life.
Conclusion
Within the limitations of this prospective case series, peri-implant soft-tissue augmentation with a porcine acellular dermal matrix showed partial volumetric maintenance over 2 years and favorable patient-reported outcomes. Controlled studies are needed to confirm these preliminary findings. PLAIN LANGUAGE SUMMARY The soft tissues surrounding dental implants contribute to their protection and appearance. When tissue volume is insufficient, surgery may be considered to increase it. This commonly involves harvesting connective tissue from the patient's palate, creating an additional surgical wound that may cause discomfort. Porcine acellular dermal matrices, derived from pig skin processed to remove cells, offer an alternative that avoids tissue harvesting. This case series examined changes in soft-tissue volume over 2 years after augmentation with a porcine acellular dermal matrix. Tissue volume was measured using repeated digital scans of the mouth. Clinical outcomes, postoperative pain, pain medication use, and oral health-related quality of life were also assessed. The initial postoperative increase in tissue volume progressively diminished, with limited remaining gains and considerable variation between implant sites at 2 years. Patients generally reported favorable oral health-related quality of life despite limited volume maintenance, while postoperative pain varied between individuals. These findings highlight that patients' perceptions and measured tissue changes reflect different aspects of treatment outcomes. This study does not establish predictable long-term tissue augmentation with the procedure investigated. Larger controlled studies are needed to determine its effectiveness and potential clinical applications.