Riccardo Di Gianfilippo1, Nicola Alberto Valente2,3, Paolo Toti4, Hom Lay Wang5, Antonio Barone6. 1. Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA. rdgianfi@umich.edu. 2. Department of Stomatology, University of Seville Faculty of Dentistry, Seville, Spain. 3. Formerly - Unit of Oral Surgery and Implantology, University Hospitals of Geneva, University of Geneva, Geneva, Switzerland. 4. Department of Multidisciplinary Regenerative Research, Guglielmo Marconi University, Rome, Italy. 5. Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA. 6. Unit of Oral Surgery, Department of Surgical, Medical, Molecular and Critical Needs Pathologies, University of Pisa, Pisa, Italy.
Abstract
PURPOSE: Marginal bone loss (MBL) is an important clinical issue in implant therapy. One feature that has been cited as a contributing factor to this bone loss is peri-implant mucosal thickness. Therefore, in this report, we conducted a systematic review of the literature comparing bone remodeling around implants placed in areas with thick (≥2-mm) vs. thin (<2-mm) mucosa. METHODS: A PICO question was defined. Manual and electronic searches were performed of the MEDLINE/PubMed and Cochrane Oral Health Group databases. The inclusion criteria were prospective studies that documented soft tissue thickness with direct intraoperative measurements and that included at least 1 year of follow-up. When possible, a meta-analysis was performed for both the overall and subgroup analyses. RESULTS: Thirteen papers fulfilled the inclusion criteria. A meta-analysis of 7 randomized clinical trials was conducted. Significantly less bone loss was found around implants with thick mucosa than around those with thin mucosa (difference, -0.53 mm; P<0.0001). Subgroups were analyzed regarding the apico-coronal positioning, the use of platform-matched vs. platform-switched (PS) connections, and the use of cement-retained vs. screw-retained prostheses. In these analyses, thick mucosa was found to be associated with significantly less MBL than thin mucosa (P<0.0001). Among non-matching (PS) connections and screw-retained prostheses, bone levels were not affected by mucosal thickness. CONCLUSIONS: Soft tissue thickness was found to be correlated with MBL except in cases of PS connections used on implants with thin tissues and screw-retained prostheses. Mucosal thickness did not affect implant survival or the occurrence of biological or aesthetic complications. TRIAL REGISTRATION: International Prospective Register of Systematic Reviews (PROSPERO): CRD42018084598.
PURPOSE:Marginal bone loss (MBL) is an important clinical issue in implant therapy. One feature that has been cited as a contributing factor to this bone loss is peri-implant mucosal thickness. Therefore, in this report, we conducted a systematic review of the literature comparing bone remodeling around implants placed in areas with thick (≥2-mm) vs. thin (<2-mm) mucosa. METHODS: A PICO question was defined. Manual and electronic searches were performed of the MEDLINE/PubMed and Cochrane Oral Health Group databases. The inclusion criteria were prospective studies that documented soft tissue thickness with direct intraoperative measurements and that included at least 1 year of follow-up. When possible, a meta-analysis was performed for both the overall and subgroup analyses. RESULTS: Thirteen papers fulfilled the inclusion criteria. A meta-analysis of 7 randomized clinical trials was conducted. Significantly less bone loss was found around implants with thick mucosa than around those with thin mucosa (difference, -0.53 mm; P<0.0001). Subgroups were analyzed regarding the apico-coronal positioning, the use of platform-matched vs. platform-switched (PS) connections, and the use of cement-retained vs. screw-retained prostheses. In these analyses, thick mucosa was found to be associated with significantly less MBL than thin mucosa (P<0.0001). Among non-matching (PS) connections and screw-retained prostheses, bone levels were not affected by mucosal thickness. CONCLUSIONS: Soft tissue thickness was found to be correlated with MBL except in cases of PS connections used on implants with thin tissues and screw-retained prostheses. Mucosal thickness did not affect implant survival or the occurrence of biological or aesthetic complications. TRIAL REGISTRATION: International Prospective Register of Systematic Reviews (PROSPERO): CRD42018084598.
Authors: José Vicente Ríos-Santos; Gregorio Tello-González; Pedro Lázaro-Calvo; Francisco Javier Gil Mur; Blanca Ríos-Carrasco; Ana Fernández-Palacín; Mariano Herrero-Climent Journal: Int J Environ Res Public Health Date: 2020-12-17 Impact factor: 3.390
Authors: Rubén Agustín-Panadero; Irene Bermúdez-Mulet; Lucía Fernández-Estevan; María Fernanda Solá-Ruíz; Rocío Marco-Pitarch; Marina García-Selva; Álvaro Zubizarreta-Macho; Raquel León-Martínez Journal: Int J Environ Res Public Health Date: 2021-05-14 Impact factor: 3.390