Soft tissue augmentation around osseointegrated and uncovered dental implants: a systematic review.

Bassetti, Renzo G; Stähli, Alexandra; Bassetti, Mario A; Sculean, Anton (2017). Soft tissue augmentation around osseointegrated and uncovered dental implants: a systematic review. Clinical oral investigations, 21(1), pp. 53-70. Springer 10.1007/s00784-016-2007-9

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OBJECTIVES The aim was to compile the current knowledge about the efficacy of different soft tissue correction methods around osseointegrated, already uncovered and/or loaded (OU/L) implants with insufficient soft tissue conditions. Procedures to increase peri-implant keratinized mucosa (KM) width and/or soft tissue volume were considered. MATERIALS AND METHODS Screening of two databases: MEDLINE (PubMed) and EMBASE (OVID), and manual search of articles were performed. Human studies reporting on soft tissue augmentation/correction methods around OU/L implants up to June 30, 2016, were considered. Quality assessment of selected full-text articles to weight risk of bias was performed using the Cochrane collaboration's tool. RESULTS Overall, four randomized controlled trials (risk of bias = high/low) and five prospective studies (risk of bias = high) were included. Depending on the surgical techniques and graft materials, the enlargement of keratinized tissue (KT) ranged between 1.15 ± 0.81 and 2.57 ± 0.50 mm. The apically positioned partial thickness flap (APPTF), in combination with a free gingival graft (FGG), a subepithelial connective tissue graft (SCTG), or a xenogeneic graft material (XCM) were most effective. A coronally advanced flap (CAF) combined with SCTG in three, combined with allogenic graft materials (AMDA) in one, and a split thickness flap (STF) combined with SCTG in another study showed mean soft tissue recession coverage rates from 28 to 96.3 %. STF combined with XCM failed to improve peri-implant soft tissue coverage. CONCLUSIONS The three APPTF-techniques combined with FGG, SCTG, or XCM achieved comparable enlargements of peri-implant KT. Further, both STF and CAF, both in combination with SCTG, are equivalent regarding recession coverage rates. STF + XCM and CAF + AMDA did not reach significant coverage. CLINICAL RELEVANCE In case of soft tissue deficiency around OU/L dental implants, the selection of both an appropriate surgical technique and a suitable soft tissue graft material is of utmost clinical relevance.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > School of Dental Medicine > Department of Periodontology
04 Faculty of Medicine > School of Dental Medicine

UniBE Contributor:

Stähli, Alexandra and Sculean, Anton

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1432-6981

Publisher:

Springer

Language:

English

Submitter:

Eveline Carmen Schuler

Date Deposited:

10 May 2017 13:09

Last Modified:

10 May 2017 13:09

Publisher DOI:

10.1007/s00784-016-2007-9

PubMed ID:

27873018

Uncontrolled Keywords:

Dental implant, Free gingival graft, Peri-implant keratinized attached mucosa, Soft tissue recession, Soft tissue volume, Subepithelial connective tissue graft, Vestibuloplasty, Xenogeneic collagen matrix

BORIS DOI:

10.7892/boris.94855

URI:

https://boris.unibe.ch/id/eprint/94855

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