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Ridge deformities can complicate prosthetic rehabilitation, especially in situations where optimal esthetic outcomes are desired. Simpler, less invasive and predictable treatments are needed in order to obtain soft tissue augmentation at edentulous ridges. Autogenous subepithelial connective tissue graft (SCTG) has always been regarded as the treatment of choice, but heterologous volume stable collagen matrix (VCMX) is emerging as a reliable alternative. The principal aim of the present RCT will be to compare the volumetric buccal soft tissue changes at edentulous areas after augmentation procedure using VCMX or SCTG. Parameters related to periodontal health at adjacent teeth and patient reported outcomes (PROMs) will be also assessed as secondary outcomes. Proving the non- inferiority of VCMX compared to SCTG would provide the specialists and general clinicians with an easier, less invasive and better tolerated technique for soft tissue augmentation at edentulous ridges and for improving aesthetic and cleansability of the prosthetic rehabilitation.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Subepithelial Connective Tissue Graft (SCTG) | Active Comparator | Soft tissue augmentation at edentulous area with subepithelial connective tissue graft harvested from the patient's palate |
|
| Volume Stable Collagen Matrix (VCMX) | Experimental | Soft tissue augmentation at edentulous area with xenogenic volume stable collagen matrix |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Soft tissue augmentation with subepithelial connective tissue graft (SCTG) | Procedure | After local anesthesia a mesio-distal crestal incision will be performed reaching the alveolar bone. Split thickness dissection performed both buccal and palatal. Subepithelial connective tissue graft will be harvested and inserted beneath the mucoperiosteal flap and stretched buccally and lingually using a modified horizontal mattress suture. The flap margins at the crest will be adapted using single interrupted sutures in order to achieve a primary closure of the flap. |
| Measure | Description | Time Frame |
|---|---|---|
| Volumetric buccal soft tissue changes (-5 to +5 mm with positive values representing an increase in volume) | Mean linear change in mm from baseline to 6 months follow-up | 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Probing Pocket Depth (PD) at adjacent teeth (0-15 mm with higher values representing worse outcomes) | The distance between cementoenamel junction (CEJ) and the base of the pocket | 6 months |
| Mucosal recession at adjacent sites (0-15 mm with higher values indicating worse outcomes) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Mario Aimetti | Contact | 00390116331546 | mario.aimetti@unito.it |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Turin | Recruiting | Turin | Italy |
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|
| Soft tissue augmentation with xenogenic volume stable collagen matrix | Procedure | After local anesthesia a mesio-distal crestal incision will be performed reaching the alveolar bone. Split thickness dissection performed both buccal and palatal. Xenogenic volume stable collagen matrix will be inserted beneath the mucoperiosteal flap and stretched buccally and lingually using a modified horizontal mattress suture. The flap margins at the crest will be adapted using single interrupted sutures in order to achieve a primary closure of the flap. |
|
The distance between the cementoenamel junction (CEJ) and the mucosal margin |
| 6 months |
| Pain (VAS scale)(0-10 with higher values indicating worse outcomes) | Subjective pain experienced by the patient expressed in a VAS scale | 2 weeks |