Impact of timing on soft tissue augmentation during implant treatment: A systematic review and meta‐analysis

Lin, Cho Ying; Chen, Zhaozhao; Pan, Whei‐Lin; Wang, Hom Lay

doi:10.1111/clr.13148

Cited by 52 publications

(42 citation statements)

References 55 publications

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“…Es necesa-Tabla I. Evaluación riesgo de sesgo, escala NEWCASTLE-OTTAWA para ensayos clínicos controlados (ECC). rio mencionar la variabilidad en las herramientas de medición de los resultados, esta variabilidad corresponde a la técnica quirúrgica realizada, para el recubrimiento de recesiones gingivales y el aumento de tejido queratinizado es ideal el empleo de herramientas bidimensionales como la fotografía clínica y la sonda periodontal (carolina del norte) y para cirugías de aumento de volumen se empleó las herramientas de medición tridimensionales como el escáner óptico intraoral, esta herramienta muestra una alta precisión, variando de 3 a 200 µm y desde 0.05 % a 1.5 % en volumen, este sistema tridimensional representa el futuro de las mediciones en la cirugía de aumento de volumen (Marzadori et al, 2018). A pesar de la variabilidad en las herramientas de medición, no se encontraron diferencias estadísticamente significativas, tanto para los estudios que emplearon instrumentos bidimensionales y tridimensionales.…”

Section: Discussionunclassified

Paladar o Tuberosidad, ¿Cuál es la Mejor Zona Donadora para un Injerto de Tejido Blando?: Una Revisión Sistemática

Ramos-Pilco

Salinas

Alarcón

2020

Int. J. Odontostomat.

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RESUMEN: Comparar mediante una revisión sistemática los resultados clínicos de los procedimientos de cirugía plástica periodontal/periimplantar (CP) con injerto de tejido blando autógeno (ITB) obtenido del área lateral del paladar (ALP) versus del área de la tuberosidad (AT). Se realizó una búsqueda electrónica de ensayos clínicos en la base de datos Medline/Pubmed, Cochrane y las revistas de Periodoncia e Implantes de mayor impacto según la Web of Science, para hallar artículos publicados hasta abril del 2020. Se valoró el riesgo de sesgo de los artículos añadidos según el manual Cochrane Versión 5.1.0 para ensayos clínicos aleatorizados y la escala Newcastle-Ottawa para ensayos clínicos controlados. De una muestra inicial de 930 artículos, cuatro ensayos clínicos (tres aleatorizados) fueron incluidos en el presente estudio, donde se realizaron un total de 87 CP alrededor de piezas e implantes dentales, de las cuales 42 cirugías fueron realizadas con ITB del ALP y 45 cirugías con ITB del AT, se evaluó los resultados desde las 8 semanas hasta los 12 meses. No se hallaron diferencias estadísticamente significativas en los resultados clínicos entre ambos grupos, se mejoró el fenotipo gingival en la zona receptora para el grupo que obtuvo el ITB del AT y el nivel del dolor del sitio donador del AT fue menor en las dos primeras semanas que el sitio donante del ALP. Los estudios incluidos manifestaron un bajo riesgo de sesgo en promedio. Ambas áreas donantes de injerto de tejido blando proporcionan resultados clínicos similares, el injerto del área de la tuberosidad mejora el fenotipo gingival de la zona receptora y reduce el dolor post operatorio en las primeras semanas del sitio donador.

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Section: Discussionunclassified

Paladar o Tuberosidad, ¿Cuál es la Mejor Zona Donadora para un Injerto de Tejido Blando?: Una Revisión Sistemática

Ramos-Pilco

Salinas

Alarcón

2020

Int. J. Odontostomat.

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“…To the best knowledge of the reviewers, the current review is the first to include only RCTs to address a well‐focused question regarding the use of CTG at the time of dental implant placement in fresh extraction sockets. Several systematic reviews were previously published to evaluate soft tissue augmentation techniques, including CTG and substitutes for CTG, at implant placement, second stage implant surgery or after implant loading. These reviews included studies of varied designs and methods for the evaluation of soft tissue alterations.…”

Section: Discussionmentioning

confidence: 99%

“…The optimal timing for soft tissue grafting remains, however, controversial. One review showed promising results with CTG whether it was used in conjunction with immediate implant placement or following the implant placement. A common recommendation in these reviews was the call for further RCTs.…”

Section: Discussionmentioning

confidence: 99%

Soft tissue changes after connective tissue grafts around immediately placed and restored dental implants in the esthetic zone: A systematic review and meta‐analysis

Atieh

Alsabeeha

2019

J Esthet Restor Dent

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Objective: The aim of this systematic review and meta-analysis was to evaluate the soft tissue outcomes of connective tissue graft (CTG) combined with immediate implant placement and restoration (IIPR) in the esthetic zone.Materials and methods: Following the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement, randomized controlled trials (RCTs) were searched for in electronic databases and complemented by hand searching. The risk of bias was assessed using the Cochrane Collaboration's Risk of Bias tool and data were analyzed using statistical software.Results: A total of 180 studies were identified, of which, four trials were included with 144 implant sites in 144 participants. Overall meta-analysis showed that CTG in conjunction with IIPR had a significantly greater gingival thickness than IIPR alone.The IIPR with CTG had less recession and higher esthetic pink score compared to IIPR group, but the difference was not statistically significant. No significant differences in implant failure rate were found between IIPR with and without CTG. Conclusions:The use of CTG in conjunction with IIPR in the esthetic zone significantly improved the thickness of the gingival tissues compared to IIPR without CTG.No significant differences were observed in the level of soft tissues around immediately placed implants with or without CTG.Clinical significance: The use of connective tissue graft with IIPR can be considered to improve the soft tissue profile and minimize mucosal recession in esthetic zone. K E Y W O R D S dental implants, gingival recession, immediate placement, meta-analysis, review

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“…The manual search period was from January 1, 2000 to March 26, 2020. Additionally, reference lists of the retrieved studies for full‐text screening and previous reviews in the topic of peri‐implant soft tissue (plastic) surgery were screened 9‐12,18,22,51,52,62‐68 …”

Section: Methodsmentioning

confidence: 99%

Peri‐implant soft tissue phenotype modification and its impact on peri‐implant health: A systematic review and network meta‐analysis

Tavelli

Barootchi

Ávila‐Ortiz

et al. 2020

Journal of Periodontology

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178

232

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Background The peri‐implant soft tissue phenotype (PSP) encompasses the keratinized mucosa width (KMW), mucosal thickness (MT), and supracrestal tissue height (STH). Numerous approaches to augment soft tissue volume around endosseous dental implants have been investigated. To what extent PSP modification is beneficial for peri‐implant health has been subject of debate in the field of implant dentistry. The aim of this systematic review was to analyze the evidence regarding the efficacy of soft tissue augmentation procedures aimed at modifying the PSP and their impact on peri‐implant health. Methods A comprehensive search was performed to identify clinical studies that involved soft tissue augmentation around dental implants and reported findings on KMW, MT, and/or STH changes. The effect of the intervention on peri‐implant health was also assessed. Selected articles were classified based on the general type of surgical approach to increase PSP, either bilaminar or an apically positioned flap (APF) technique. A network meta‐analysis including only randomized‐controlled trials (RCTs) reporting on PSP outcomes was conducted to assess and compare different techniques. Results A total of 52 articles were included in the qualitative analysis, and 23 RCTs were included as part of the network meta‐analysis. Sixteen RCTs reported the outcomes of PSP modification therapy with bilaminar techniques, whereas 7 involved the use of APF. The analysis showed that bilaminar techniques in combination with soft tissue grafts (connective tissue graft [CTG], collagen matrix [CM], and acellular dermal matrix [ADM]) resulted in a significant increase in MT compared to non‐augmented sites. In particular, CTG and ADM were associated with higher MT gain as compared to CM and non‐augmented sites. However, no significant differences in KMW were observed across different bilaminar techniques. PSP modification via a bilaminar approach utilizing either CTG or CM showed beneficial effects on marginal bone level stability. APF‐based approaches in combination with free gingival graft (FGG), CTG, CM, or ADM showed a significant KMW gain compared to non‐augmented sites. However, compared to APF alone, only FGG exhibited a significantly higher KMW gain. APF with any evaluated soft tissue graft was associated with with reduction of probing depth, soft tissue dehiscence and plaque index compared to non‐augmented sites compared to non‐augmented sites. The evidence regarding the effect of PSP modification via APF‐based approaches on peri‐implant marginal bone loss or preservation is inconclusive. Conclusions Bilaminar approach involving CTG or ADM obtained the highest amount of MT gain, whereas APF in combination with FGG was the most effective technique for increasing KMW. KMW augmentation via APF was associated with a significant reduction in probing depth, soft tissue dehiscence and plaque index, regardless of the soft tissue grafting material employed, whereas bilaminar techniques with CTG or CM showed beneficial effects on marginal bone lev...

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Impact of timing on soft tissue augmentation during implant treatment: A systematic review and meta‐analysis

Cited by 52 publications

References 55 publications

Paladar o Tuberosidad, ¿Cuál es la Mejor Zona Donadora para un Injerto de Tejido Blando?: Una Revisión Sistemática

Paladar o Tuberosidad, ¿Cuál es la Mejor Zona Donadora para un Injerto de Tejido Blando?: Una Revisión Sistemática

Soft tissue changes after connective tissue grafts around immediately placed and restored dental implants in the esthetic zone: A systematic review and meta‐analysis

Peri‐implant soft tissue phenotype modification and its impact on peri‐implant health: A systematic review and network meta‐analysis

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