The "HAT-TRICK" technique: A modification of soft tissue grafting using volume stable collagen matrix and cross-linked hyaluronic acid. Part A: The pontic site

Bachar Husseini; Anton Friedmann; Ralph Wak; Nabil Ghosn; Karim Senni; Sylvie Changotade; Georges Khoury; Ronald Younes

doi:10.1016/j.jormas.2023.101754

The "HAT-TRICK" technique: A modification of soft tissue grafting using volume stable collagen matrix and cross-linked hyaluronic acid. Part A: The pontic site

J Stomatol Oral Maxillofac Surg. 2023 Dec 28;125(5):101754. doi: 10.1016/j.jormas.2023.101754. Online ahead of print.

Authors

Bachar Husseini¹, Anton Friedmann², Ralph Wak³, Nabil Ghosn⁴, Karim Senni⁵, Sylvie Changotade⁶, Georges Khoury⁷, Ronald Younes⁸

Affiliations

¹ Private Practice, Beirut, Lebanon. Electronic address: basharhusseini@hotmail.com.
² Department of Periodontology, Faculty of Health, Witten/Herdecke University, Witten 58455, Germany.
³ Private Practice, Beirut, Lebanon.
⁴ Cranio-Facial Research Laboratory, Faculty of Dental Medicine, Saint-Joseph University of Beirut, Beirut, Lebanon.
⁵ Unité de Recherche EBInnov, Ecole de Biologie Industrielle-EBI, Cergy 95895, France.
⁶ Unité de Recherche en Ingénierie Tissulaire-URIT, Sorbonne Paris Nord University, Bobigny 93000, France.
⁷ Department of Advanced Surgical Implantology, Service of Odontology, U.F.R. of Odontology, Rothschild Hospital, AP-HP, University Denis Diderot, Paris, France.
⁸ Department of Oral Surgery, Faculty of Dental Medicine, Saint-Joseph University of Beirut, Beirut, Lebanon.

PMID: 38159906
DOI: 10.1016/j.jormas.2023.101754

Abstract

Vertical soft tissue augmentation between implants can be clinically challenging and burdensome for patients when employing conventional techniques. Recently, with the introduction of xenogenic collagen matrices, the principle of single-site surgery has become more common. However, some issues persist regarding graft stability and tissue integration. In the present technical note, the authors introduce the "HAT-TRICK" technique to address these observed difficulties. As the name suggests, this technique is believed to provide improved stability, volumetric gain, and histological integration of the implanted matrix by shaping it appropriately resembling a hat over the crest with apical bevels, stabilized with fixation pins and infused with cross-linked hyaluronic acid (xHya). A two-month observation of a bi-maxillary case is presented with detailed description of the technique and digitalized comparison methods for an easier explanation of the introduced technique.

Keywords: Collagen matrix; Digital imaging software; Hyaluronic acid; Implants; Pontic sites; Soft tissue grafting.