Recently, porcine acellular dermal matrix (Mucoderm®) has become an alternative to connective tissue autografts in periodontal surgery. For the experimental purpose of using an alternative material to autologous connective tissue we selected a case of keratinized gingival augmentation. The expected results had been disappointing, which led us to ask the problem of the evolution in situ of this matrix and the reality of its bio-integration.
We investigated in vivo human biopsy taken from patient who underwent xenogenic dermal transplant. Biopsy obtained at 11 weeks post-tissue transplant
and stained with Hematoxylin-Eosin demonstrated the presence of numerous inflammatory cells in the connective gingival tissue at the periphery of ulceration inside of which many foreign body giant cells constitute a granuloma; similarly, newly formed collagen fibers are present, very dense and reminiscent of fibrotic tissue.
This relative clinical failure can thus reveal the poor bio-integration of the material related to its macromolecular structure and poor colonization of this matrix by cells such as gingival fibroblasts, but also by extension to poor neoangiogenesis.