Blood flow kinetics of a xenogeneic collagen matrix following a vestibuloplasty procedure in the human gingiva—An explorative study

• Published in: Oral diseases Vol. 25; no. 7; pp. 1780 - 1788
• Main Authors: Fazekas, Réka, Molnár, Bálint, Kőhidai, László, Láng, Orsolya, Molnár, Eszter, Gánti, Bernadett, Michailovits, Georgina, Windisch, Péter, Vág, János
• Format: Journal Article
• Language: English
• Published: Denmark Wiley Subscription Services, Inc 01.10.2019
• Subjects: Adolescent; Adult; angiogenesis; Blood flow; Collagen; collagen graft; Dentistry; Gingiva; Gingiva - transplantation; Heterografts; Humans; Ischemia; Keratins; Kinetics; laser speckle; Mandible - surgery; Membranes, Artificial; Middle Aged; Mucosa; Perfusion; Prospective Studies; Surgical Flaps; Treatment Outcome; Vascular endothelial growth factor; Vascularization; vestibuloplasty; Vestibuloplasty - adverse effects; Vestibuloplasty - methods; Wound Healing - physiology; Wounds; Young Adult; laser speckle; collagen graft; vestibuloplasty; blood flow; angiogenesis; vascular endothelial growth factor
• ISSN: 1354-523X; 1601-0825
• DOI: 10.1111/odi.13163

Objectives The aim of the present study was to investigate temporal and spatial blood flow patterns following vestibuloplasty procedures using a collagen matrix (CM) to get an insight into the timing and direction of neovascularization in the CM. Methods Five patients were treated using a modified apically repositioned flap combined with a CM. Intraoral photographs and blood flow measurements by laser speckle contrast imaging were taken for 12 months. Thirty regions of interest in the graft and the surrounding mucosa were evaluated. The clinical parameters were assessed after 6 and 12 months. VEGF expression was analyzed in the wound fluid on days 2 and 4. Results At 6 months, the mean width of keratinized gingiva increased, but the thickness was unchanged. Scar formation was observed in all cases. Perfusion in the graft began to increase at the lateral and coronal edges and then spread concentrically toward the center. The apical side showed a significant delay in perfusion, the highest VEGF expression, and wound fluid production as well as the most abundant scar formation. Conclusions Neovascularization occurs mainly from the lateral and coronal edges, which may limit the extent of the surgical area. Abundant scar formation may be explained by increased VEGF expression induced by prolonged ischemia in this area.