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.
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
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:
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.
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
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.