Comparison of Vestibular Depth Relapse and Wound Healing After Reconstructive Preprosthetic Surgery Using Cryopreserved Amniotic Membrane and Acellular Dermal Matrix - A Comparative Study

Danial Babaki; Masoumeh Khoshsimaybargard; Sanam Yaghoubi; Mahdi Gholami

doi:10.4103/ams.ams_322_20

Comparison of Vestibular Depth Relapse and Wound Healing After Reconstructive Preprosthetic Surgery Using Cryopreserved Amniotic Membrane and Acellular Dermal Matrix - A Comparative Study

Ann Maxillofac Surg. 2021 Jan-Jun;11(1):12-16. doi: 10.4103/ams.ams_322_20. Epub 2021 Jul 24.

Authors

Danial Babaki¹, Masoumeh Khoshsimaybargard², Sanam Yaghoubi³, Mahdi Gholami^{4

5}

Affiliations

¹ Department of Biomedical Engineering, Tagliatela College of Engineering, University of New Haven, CT, USA.
² Private Practice, Department of Gynaecology, Mashhad University of Medical Sciences, Mashhad, Iran.
³ Genetics Department, Center for Cancer Research, National Cancer Institute, NIH, Bethesda, MD, USA.
⁴ Department of Oral and Maxillofacial Surgery, Mashhad University of Medical Sciences, Mashhad, Iran.
⁵ Oral and Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

Abstract

Introduction: The significance of membranes as wound dressing in oral surgeries has been reported by previous studies. The aim of the present split-mouth randomized clinical study was to assess and compare the wound dressing properties of acellular dermal matrix (ADM) and cryopreserved human amniotic membrane (AM) after reconstructive preprosthetic oral surgery.

Materials and methods: Twenty-eight patients with complete mandibular edentulism and resorbed alveolar bone were included. After taking mandibular impression, a clear acrylic splint with increased labial flange height was created. In each participant, labial vestibular depth was elevated using the Clark's technique. Subsequently, half of the exposed periosteum was covered with ADM while the other half was covered with cryopreserved human AM. Vestibule depth and relapse in the two sides were measured immediately after vestibuloplasty and at the end of the 1^st week, 2^nd week, 1^st month, and 3^rd months with graduations of 0.1 mm. Furthermore, after 3 and 7 days, samples were collected from graft material, and the macrophage population was analyzed by flow cytometry.

Results: There was no significant difference in the relapse of vestibule depth between the two grafts at different time intervals. However, the frequency of wound-infiltrating macrophages (CD68⁺ cells) was significantly higher in areas covered by ADM after 3 and 7 days.

Discussion: ADM is as effective as cryopreserved AM in terms of maintaining the postoperative vestibular depth. On the other hand, our results suggested that the onset of healing phase in ADM-covered areas occurs faster compared to the periosteum covered with cryopreserved human AM. This clinical trial showed significantly faster postoperative healing onset when ADM was used than when cryopreserved human AM was applied on the periosteum.

Keywords: Acellular dermal matrix; CD68+ cell; cryopreserved human amniotic membrane; vestibular depth; vestibuloplasty.