Tommasato, Grazia; Del Fabbro, Massimo; Oliva, Nadim; Khijmatgar, Shahnawaz; Grusovin, Maria Gabriella; Sculean, Anton; Canullo, Luigi (2024). Autogenous graft versus collagen matrices for peri-implant soft tissue augmentation. A systematic review and network meta-analysis. Clinical oral investigations, 28(5) Springer 10.1007/s00784-024-05684-5
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OBJECTIVE
The primary objective of this review is to compare autogenous soft tissue grafts (connective tissue graft - CTG and free gingival graft-FGG) with different type of matrices (acellular dermal matrix-ADM, xenograft collagen matrix-XCM, volume-stable collagen matrix-VCMX) used to increase peri-implant soft tissues.
MATERIALS AND METHODS
A search on electronic databases was performed to identify randomized and non-randomized controlled trials (RCTs and CCTs, respectively) with either parallel or split-mouth design, and treating ≥ 10 patients. A network meta-analysis (NMA) was used to compare different matrices. Soft tissue thickness dimensional changes and keratinized width (KMW) changes were the primary outcome measures. The secondary outcomes were to evaluate: a) PROMs; b) volumetric changes; c) surgical operating time; and d) different periodontal measurements.
RESULTS
A total of 23 studies were included in the qualitative analysis, and 16 studies (11 RCTs and 5 CCTs) in the quantitative analysis. A total of N = 573 sites were evaluated for NMA. CTG resulted the best material for increasing peri-implant soft tissue thickness, at 180 and 360 days after surgery. The use of an ADM showed good results for buccal thickness increase, primarily in the first three months after surgery. Vestibuloplasty + FGG resulted in the most effective technique for peri-implant KMW augmentation, after 180 days.
CONCLUSIONS
While CTG demonstrated better performance in all the comparison and FGG showed to be the best graft to increase keratinized mucosa up to 90 days, ADM and VCMX may be used to increase soft tissue horizontal thickness with lower patients' morbidity.
LIMITATIONS
The limits of this NMA are the following: a) limited number of included studies; b) high heterogeneity among them (number of patients, treatment sites, surgical techniques, outcome measures, and follow-ups).
CLINICAL RELEVANCE
Many studies compared the efficacy of autogenous and non-autogenous grafts in terms of gingival thickness, volume, and keratinized width increase. However, there is still not clear overall evidence on this topic. This NMA helps clinicians to choose the right material in different peri-implant soft tissue procedures. Recommendations for future studies are mandatory.
Item Type: |
Journal Article (Further Contribution) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > School of Dental Medicine > Department of Periodontology |
UniBE Contributor: |
Sculean, Anton |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
1436-3771 |
Publisher: |
Springer |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
06 May 2024 08:43 |
Last Modified: |
07 May 2024 05:34 |
Publisher DOI: |
10.1007/s00784-024-05684-5 |
PubMed ID: |
38704784 |
Uncontrolled Keywords: |
Connective tissue graft Dimensional changes Network Meta-Analysis Peri-implant soft tissue augmentation Systematic Review Xenogeneic collagen matrix |
BORIS DOI: |
10.48350/196535 |
URI: |
https://boris.unibe.ch/id/eprint/196535 |
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