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Kaner, Dogan; Zhao, Han; Terheyden, Hendrik; Friedmann, Anton

Improvement of microcirculation and wound healing in vertical ridge augmentation after pre‐treatment with self‐inflating soft tissue expanders – a randomized study in dogs

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  • Media type: E-Article
  • Title: Improvement of microcirculation and wound healing in vertical ridge augmentation after pre‐treatment with self‐inflating soft tissue expanders – a randomized study in dogs
  • Contributor: Kaner, Dogan; Zhao, Han; Terheyden, Hendrik; Friedmann, Anton
  • imprint: Wiley, 2015
  • Published in: Clinical Oral Implants Research
  • Language: English
  • DOI: 10.1111/clr.12377
  • ISSN: 0905-7161; 1600-0501
  • Keywords: Oral Surgery
  • Origination:
  • Footnote:
  • Description: <jats:title>Abstract</jats:title><jats:sec><jats:title>Objectives</jats:title><jats:p>We investigated the effect of soft tissue expansion (<jats:styled-content style="fixed-case">STE</jats:styled-content>) on vertical ridge augmentation with regard to the incidence of wound dehiscences and the impairment of microcirculation in dogs, and the applicability of laser Doppler flowmetry (<jats:styled-content style="fixed-case">LDF</jats:styled-content>) to explore the relation between microcirculation and wound healing.</jats:p></jats:sec><jats:sec><jats:title>Material and methods</jats:title><jats:p>Bone defects were created on both mandibular sides in ten beagle dogs by extraction of premolars and removal of bone. Six weeks later, self‐filling tissue expanders were implanted in randomly assigned test sites. After 5 weeks of expansion, vertical augmentation was carried out in test and control sites using calvarial onlay grafts side by side with granular biphasic calcium phosphate covered with a resorbable polyethylene glycol membrane. Microcirculation was evaluated with laser Doppler flowmetry (<jats:styled-content style="fixed-case">LDF</jats:styled-content>). The incidence of wound dehiscences was evaluated after 2 weeks. The validity of <jats:styled-content style="fixed-case">LDF</jats:styled-content> to predict dehiscences was evaluated by construction of receiver operating characteristic (<jats:styled-content style="fixed-case">ROC</jats:styled-content>) curves.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>After augmentation, test sites showed significantly better perfusion than control sites without preceding <jats:styled-content style="fixed-case">STE</jats:styled-content> (<jats:italic>P</jats:italic> = 0.012). Three days after surgery, perfusion was still significantly decreased in control sites (<jats:italic>P</jats:italic> = 0.005), while microcirculation in test sites had returned to pre‐surgical levels. After 2 weeks, healing in test sites was good, whereas eight dehiscences were found in control sites (<jats:italic>P</jats:italic> = 0.002). <jats:styled-content style="fixed-case">ROC</jats:styled-content> curves showed that microcirculation levels immediately after augmentation surgery significantly predicted subsequent wound dehiscences (<jats:styled-content style="fixed-case">AUC</jats:styled-content> = 0.799, <jats:styled-content style="fixed-case">CI</jats:styled-content> 0.642–0.955, <jats:italic>P</jats:italic> = 0.006).</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Laser Doppler flowmetry is suitable for evaluation of soft tissue microcirculation after ridge augmentation. <jats:styled-content style="fixed-case">STE</jats:styled-content> reduced the impairment of microcirculation caused by vertical ridge augmentation and decreased the incidence of wound dehiscences in the investigated animal model.</jats:p></jats:sec>