Francesco Cairo1, Luigi Barbato1, Filippo Selvaggi1, Maria G Baielli1, Adriano Piattelli2,3,4, Leandro Chambrone5,6. 1. Research Unit in Periodontology and Periodontal Medicine, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy. 2. Department of Medical, Oral and Biotechnological Sciences, G. D'Annunzio University of Chieti-Pescara, Chieti, Italy. 3. Chair of Biomaterials Engineering, Catholic University of San Antonio of Murcia (UCAM), Murcia, Spain. 4. Villaserena Foundation for Research, Città Sant'Angelo, Pescara, Italy. 5. School of Dentistry, Ibirapuera University (Unib), São Paulo, Brazil. 6. Unit of Basic Oral Investigation (UIBO), School of Dentistry, El Bosque University, Bogota, Colombia.
Abstract
BACKGROUND: Different procedures were proposed to augment soft tissue around dental implants. OBJECTIVE: Aims of this Systematic Review (SR) were to evaluate (a) clinical benefit of soft tissue augmentation at implant sites (b) which is the best surgical procedure to augment soft tissue. MATERIALS AND METHODS: Manual/electronic searches were performed to identify randomized controlled trials (RCTs). Change in keratinized tissue thickness (STT) and height (KT) were primary outcomes. Random effects meta-analyses were performed where suitable and expressed as weighted mean differences (MD) with their associated 95% confidence intervals (CI). RESULTS: Fourteen RCTs accounting for 475 patients and 538 implants were included. Only five studies were judged at low risk of bias. In the single studies, soft augmentation lead to higher STT and KT compared to no augmentation. Considering primary outcomes, connective tissue graft (CTG) was more effective than xenogeneic collagen matrix (XCM) to improve STT (MD: -0.30 mm; 95% CI -0.43; -0.17; P < .00001) in the meta-analysis for different techniques for augmentation. CONCLUSIONS: Even if further studies at low risk of bias are needed, soft tissue augmentation techniques improved quantity and quality of peri-implant soft tissue. Among the augmentation procedures, CTG was associated to higher STT change compared to XCM.
BACKGROUND: Different procedures were proposed to augment soft tissue around dental implants. OBJECTIVE: Aims of this Systematic Review (SR) were to evaluate (a) clinical benefit of soft tissue augmentation at implant sites (b) which is the best surgical procedure to augment soft tissue. MATERIALS AND METHODS: Manual/electronic searches were performed to identify randomized controlled trials (RCTs). Change in keratinized tissue thickness (STT) and height (KT) were primary outcomes. Random effects meta-analyses were performed where suitable and expressed as weighted mean differences (MD) with their associated 95% confidence intervals (CI). RESULTS: Fourteen RCTs accounting for 475 patients and 538 implants were included. Only five studies were judged at low risk of bias. In the single studies, soft augmentation lead to higher STT and KT compared to no augmentation. Considering primary outcomes, connective tissue graft (CTG) was more effective than xenogeneic collagen matrix (XCM) to improve STT (MD: -0.30 mm; 95% CI -0.43; -0.17; P < .00001) in the meta-analysis for different techniques for augmentation. CONCLUSIONS: Even if further studies at low risk of bias are needed, soft tissue augmentation techniques improved quantity and quality of peri-implant soft tissue. Among the augmentation procedures, CTG was associated to higher STT change compared to XCM.
Authors: Algirdas Puisys; Viktorija Auzbikaviciute; Egle Vindasiute-Narbute; Saulius Zukauskas; Dainius Razukevicus; Michel M Dard Journal: Clin Exp Dent Res Date: 2021-07-10