Supercritical Carbon Dioxide Decellularized Porcine Dermal Matrix Accelerated Gingival Keratinization by Modified Apically Positioned Flap Technique

Abstract

Dental implants need long-term support, therefore keratinized gingival tissue plays a vital role. Keratinized gingiva aids to maintain oral health, preventing gum recession, and in total esthetics. Thin gingiva needs to be keratinized to increase the thickness for fixing dental implants. To assess the effectiveness of supercritical carbon dioxide (scCO2) decellularized porcine dermal matrix enabled guided tissue regeneration (GTR) on mucogingival keratinization by a modified apically positioned flap (APF) partial-thickness in patients. scCO2 decellularized dermal matrix implants were placed on the available ridge with a limited width (< 2 mm) of the gingiva in 10 patients. A modified APF partial-thickness was performed with a scCO2 decellularized dermal matrix. The alterations in the thickness of keratinized gingiva (KG) and location of the mucogingival junction (MGJ) following modified APF and the location of the mucosal boundary were evaluated. This study demonstrated excellent gingival keratinization in a short time after the implantation of the scCO2 decellularized dermal matrix in the mandibles by the modified APF partial-thickness technique. The scCO2 decellularized dermal matrix implantation was done by modified APF to maintain mucosal health and aesthetics. The increase in the thickness of KG was 4–6 mm, in some cases up to 10 mm thick, the MGJ is repositioned coronally within 3–5 weeks of APF. Gingiva had significant keratinization for the attachment of healing abutment and subsequent temporary crown fixing. The scCO2 decellularized dermal matrix implantation using a modified APF partial-thickness technique accelerated substantial keratinization of the gingiva within the limitations of the present study, along with superior professional esthetic perception.