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Next generation of tissue augmentation: Performance and safety of NovoMatrix
BASEL, Switzerland/Birmingham, Ala., US: NovoMatrix reconstrictive tissue matrix remodels into the patient’s own tissue. This results in improved bone regeneration and enhanced soft-tissue quality and aesthetics. NovoMatrix is a complex acellular dermal matrix with growth factor binding sites and blood vessel architecture and consists of tissue-engineered porcine material. It is a breakthrough in xenogeneic processing that ensures a structurally intact, undamaged scaffold that supports cell and microvascular ingrowth.
Autogenous soft-tissue grafts are considered the gold standard for reconstructive periodontal surgery (e.g. root coverage, soft-tissue volume increase and keratinised tissue width increase around teeth and implants). Periodontal procedures have been recommended to achieve favourable biological, functional and aesthetic long-term outcomes in periodontal, implant and prosthodontic treatments.
Most recently, a systematic review of peri-implant soft-tissue augmentation concluded that autogenous soft-tissue grafting around implants increased the width of keratinised mucosa, resulting in overall improved tissue health, including reduction of inflammation parameters and maintenance of crestal bone levels.
In addition, a vertical soft-tissue thickness of 2 mm or greater around implants has been proved to be important in the minimisation of crestal bone remodelling and less radiographic marginal bone loss occurred in implants with thick or thickened peri-implant soft tissue.
Despite the established advantages of soft-tissue grafting around teeth and implants, autogenous grafts have limitations, including limited graft supply, increased surgical time, increased morbidity to the patient and increased risk of complications. Therefore, alternative soft-tissue grafting substitutes have been introduced and utilised in periodontal procedures to overcome the shortcomings of autogenous grafts.
These materials include a well-documented porcine-derived acellular dermal matrix, initially developed as a soft-tissue patch for the surgical repair of soft-tissue membranes, such as breast reconstruction, abdominal wall repair and hernia repair, that was later adopted under the NovoMatrix brand for dental applications, including root coverage procedures, to increase keratinised tissue and facilitate alveolar ridge reconstruction.
NovoMatrix is free of donor cells, minimising the risk of immunogenic rejection, and contains components of the natural extracellular matrix, such as fibronectin, elastin, hyaluronic acid and proteoglycans with an array of fibrillar collagens.
The proprietary tissue processing allows for an intact structure and undamaged scaffold, which in turn enables optimal cell migration, penetration and revascularisation. The result is aesthetically appealing soft-tissue regeneration with minimal inflammation and an architecture similar to the host’s tissue. NovoMatrix is supplied in a pre-hydrated state in an aqueous phosphate-buffered solution containing matrix stabilisers and therefore can be used immediately without extensive rehydration.
Pre-hydrated NovoMatrix is easy to process, and handling is similar to that of autologous tissue from the palate. This is enormously important for clinicians in order to be able to use the matrix easily in everyday practice.
NovoMatrix provides several advantages for periodontal reconstructive surgery. For root coverage, the membrane is available in a variety of sizes, allowing the coverage of multiple recessions in one session. It can be threaded in a tunnel preparation that is, in turn, shifted coronally. This results in thickened soft tissue and coverage of the recession while maintaining natural colouration of the gingiva. For soft-tissue thickening, NovoMatrix can be inserted at the buccal aspect of implants through a crestal pouch or sutured on to the periosteum to achieve thickening of the vestibular mucosa and attached soft tissue around the implant. To create an attached gingiva, NovoMatrix can be applied to a prepared soft-tissue bed similar to a free gingival graft and undergo open healing to create a band of attached gingiva. Clinical cases document that NovoMatrix is also frequently used for soft-tissue thickening around implants as well as in conjunction with guided bone regeneration procedures.
For the full article with clinical references, please visit www.biohorizonscamlog.com.