Biology of soft tissue wound healing and regeneration : consensus report of group 1 of the 10th European workshop on periodontology

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Biology of soft tissue wound healing and regeneration : consensus report of group 1 of the 10th European workshop on periodontology

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Publication Article, other scientific
Title Biology of soft tissue wound healing and regeneration : consensus report of group 1 of the 10th European workshop on periodontology
Author(s) Hämmerle, Christoph H F ; Giannobile, William V ; Abrahamsson, Ingemar ; Blanco, Juan ; Bosshardt, Dieter ; Dahlin, Christer ; Donos, Nikos ; Ellingsen, Jan Eirik ; Fickl, Stefan ; Gruber, Reinhard ; Goerlach, Goerlach ; Nuñez, Javier ; Meyle, Joerg ; Schwarz, Frank ; Sculean, Anton ; Stavropoulos, Andreas ; Terheyden, Hendrik ; Vignoletti, Fabio ; Weber, Franz
Date 2014
English abstract
BACKGROUND:The scope of this consensus was to review the biological processes of soft tissue wound healing in the oral cavity and to histologically evaluate soft tissue healing in clinical and pre-clinical models. AIMS:To review the current knowledge regarding the biological processes of soft tissue wound healing at teeth, implants and on the edentulous ridge. Furthermore, to review soft tissue wound healing at these sites, when using barrier membranes, growth and differentiation factors and soft tissue substitutes. COLLECTION OF DATA:Searches of the literature with respect to recessions at teeth and soft tissue deficiencies at implants, augmentation of the area of keratinized tissue and soft tissue volume were conducted. The available evidence was collected, categorized and summarized. FUNDAMENTAL PRINCIPLES OF ORAL SOFT TISSUE WOUND HEALING:Oral mucosal and skin wound healing follow a similar pattern of the four phases of haemostasis, inflammation, proliferation and maturation/matrix remodelling. The soft connective tissue determines the characteristics of the overlaying oral epithelium. Within 7-14 days, epithelial healing of surgical wounds at teeth is completed. Soft tissue healing following surgery at implants requires 6-8 weeks for maturation. The resulting tissue resembles scar tissue. Well-designed pre-clinical studies providing histological data have been reported describing soft tissue wound healing, when using barrier membranes, growth and differentiation factors and soft tissue substitutes. Few controlled clinical studies with low numbers of patients are available for some of the treatments reviewed at teeth. Whereas, histological new attachment has been demonstrated in pre-clinical studies resulting from some of the treatments reviewed, human histological data commonly report a lack of new attachment but rather long junctional epithelial attachment and connective tissue adhesion. Regarding soft tissue healing at implants human data are very scarce. CONCLUSIONS:Oral soft tissue healing at teeth, implants and the edentulous ridge follows the same phases as skin wound healing. Histological studies in humans have not reported new attachment formation at teeth for the indications studied. Human histological data of soft tissue wound healing at implants are limited. CLINICAL RECOMMENDATIONS:The use of barriers membranes, growth and differentiation factors and soft tissue substitutes for the treatment of localized gingival/mucosal recessions, insufficient amount of keratinized tissue and insufficient soft tissue volume is at a developing stage.
DOI http://dx.doi.org/10.1111/jcpe.12221 (link to publisher's fulltext)
Publisher Wiley
Host/Issue Journal of clinical periodontology;Special issue
Volume 41
ISSN 0303-6979
Pages S1-S5
Language eng (iso)
Subject(s) barrier membranes
growth and differentiation factors
human histology
oral soft tissue
periodontal/peri-implant wound healing
pre-clinical studies
scaffolds
soft tissue substitutes
Medicine
Research Subject Categories::ODONTOLOGY
Handle http://hdl.handle.net/2043/17699 (link to this page)

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