A fibrin matrix, or fibrin-rich matrix, is a provisional matrix provided by the fibrin clot and fibronectin during the first phase of wound healing. The fibrin matrix secretes chemicals that summon monocytes, fibroblasts, and epidermal cells to the area of the body that requires healing, thus promoting the healing process. The term may also refer to a membrane-like matrix derived from autologous blood which is strong and pliable. It functions as either a standalone product or can be mixed with other biomaterials to improve wound healing and promote tissue regeneration. In dental applications, a platelet-rich fibrin matrix can be applied following a surgical procedure to speed the healing process. The fibrin matrix also has the capacity to reduce inflammation and swelling and can be used even in advanced surgical techniques. Following implant or grafting procedures, a fibrin matrix can be utilized to speed wound healing and aid in patient recovery.
A fibroblast is a type of cell found within the connective tissues that are responsible for the synthesis of collagen and ground substance. In dentistry, fibroblasts play an important role in the integration of and implant, prosthesis, or restoration. The most common types of fibroblasts involved with dental processes are gingival fibroblasts and periodontal ligament fibroblasts. They are responsible for the synthesis and organization of the collagen fibers that connect the gingiva and alveolar bone to the cementum tooth covering. In addition, fibroblasts also secrete a growth factor that stimulates tissue regeneration in dental pulp cells and the dentin-pulp complex following a tooth injury or oral surgery. Due to the tissue trauma caused by an oral surgery or implant, multiple types of cells are required to repair and regenerate the damaged tissues. Due to the responsibilities of fibroblast cells, they are among some of the most important factors in proper healing and implant success.
Fibronectin is a glycoprotein of high-molecular weight (~440kDa) and is part of the extracellular matrix. It binds to membrane-spanning receptor proteins called integrins before then binding to extracellular matrix components such as collagen, fibrin, and heparan sulfate proteoglycans (syndecans). Fibronectin helps in the promotion of cellular migration and adhesion and is involved in the accumulation of platelets to the site of a wound. Fibronectin is therefore an essential part of the wound healing process and is also a critical part in cell differentiation in the development of vertebrates. In dental applications and implant surgeries, fibronectin can positively affect fibroblast attachment in the gingiva and prevent inflammation-driven breakdown of the tissues around the implant. Though a variety of scientific studies have been conducted on the efficacy of applying fibronectin directly to the wound site following a dental procedure, the results have been inconclusive. However, the wound-healing role of fibronectin naturally present in the body is indisputable.
Fibrous connective tissue is composed of parallel bundles of collagen fibers. It is found in the dermis, tendons, and ligaments and can also be referred to as dense connective tissue. In dental applications, fibrous connective tissue makes up an important part of the oral anatomy and has the ability to interact with dental implants. Fibrous connective tissue has been found to attach to dental implants at specific locations superior to the crestal bone and inferior to the junctional epithelium. The attachment of the connective tissue to the implant seems to strengthen previous findings about the long-term success of implants and their relationship with the surrounding tissues. Since one of the major roles of fibrous connective tissue is to provide support to surrounding bone, tissue, and organs, its re-growth at implant sites means the implant may have some of the same structural support as natural teeth.
Fibrous encapsulation refers to the layer of fibrous connective tissue that is formed between a dental implant and surrounding bone. Following implant surgery, the implant should begin to integrate with the nearby hard and soft tissues of the mouth. Though osseointegration is frequently written of post implant, the integration that takes place between the implant components and the connective tissues at the site is also important to implant stability and longevity. Fibrous connective tissue has several functions, one of the primary being to provide support to surrounding tissues. Therefore, the successful re-growth of fibrous connective tissue in developing a fibrous encapsulation between the bone and the implant provides additional support to the dental prosthesis and increases the likelihood of long-term retention. Not only does this connective tissue anchor the implant more securely to the bone but to the surrounding teeth, tissues, and oral framework which gives the prosthesis a greater chance for success.