The effect of soft tissue augmentation on the clinical and radiographical outcomes following immediate implant placement and provisionalization: a systematic review and meta-analysis

Abstract

Background Nowadays, due to the esthetic and social demands of patients, conventional staged protocols seem to be increasingly replaced by faster, one-step protocols. The purpose of the present systematic review is to assess the peri-implant soft tissue changes after immediate implant placement and provisionalization (IIPP) comparing patients treated with or without a sub-epithelial connective tissue graft (SCTG) when replacing a single tooth in the esthetic region. Methods The present systematic review was written following the PRISMA checklist. Immediate implants placed with a connective tissue graft and without one were compared. The researched primary outcomes were the mid-buccal mucosa level (MBML) facial soft tissue thickness (FSTT) and marginal bone loss (MBL). The weighted mean differences (WMD) were estimated for all three outcomes. Results The change in the mid-buccal mucosa level in the intervention group was significantly higher (WMD 0.54; 95% CI 0.33–0.75), with no indication of heterogeneity (I2 = 16%). The facial soft tissue thickness increased significantly in the intervention group (WMD 0.79; 95% CI 0.37–1.22). The marginal bone loss was significantly higher in the control group (WMD 0.13; 95% CI 0.07–0.18), with no indication of heterogeneity (I2 = 0%). Conclusions The results of the meta-analyses showed a statistically significant reduced change of the marginal bone loss and vestibular recession, as well as higher soft tissue thickness, when a graft was used. The included studies had a short observation time; therefore, studies with longer follow-ups are needed to confirm these findings.

Facial implant gingival level and thickness changes following maxillary anterior immediate tooth replacement with scarf‐connective tissue graft: A 4–13‐year retrospective study

“…On the other hand, when C‐CTG was performed in conjunction with IIPP, the resulting gingival thickness has been shown to be adequate in concealing various implant restorative materials 27 . Numerous studies have since been conducted and reached the same conclusion regarding effectiveness of C‐CTG at time of IIPP 12,25,26,29–31 . In this study, the mean MFGT at T2 (2.5 mm [1.8–3.5]) after a mean follow‐up time of 2.3 years, demonstrating the effectiveness of Scarf‐CTG in thickening the facial gingiva.…”

“…27 Numerous studies have since been conducted and reached the same conclusion regarding effectiveness of C-CTG at time of IIPP. 12,25,26,[29][30][31] In this study, the mean MFGT at T2 (2. The survival of the connective tissue grafts depends on graft vascularization and stabilization.…”

Does simultaneous soft tissue augmentation around immediate or delayed dental implant placement using sub-epithelial connective tissue graft provide better outcomes compared to other treatment options? A systematic review and meta-analysis

“…Recently, Stefan, et al conducted a systematic review and they reported that soft tissue augmentation is beneficial regarding width of keratinized mucosa and midfacial recession and showed no influence regarding peri implant MBL [ 21 ]. Similarly, Angelis et al found that SCTG improve peri implant soft tissue thickness and alleviate soft tissue recession and marginal bone loss when placed simultaneously with IIP protocol [ 22 ]. However, there is a lack of clear evidence regarding the clinical and aesthetic benefits of simultaneous soft tissue augmentation around immediate or delayed dental implant placement using SCTG compared with no grafting (with or without GBR) or with different augmentation procedures (CM and ADM).…”

Can the Immediate Implantation With Immediate Loading Achieve an Acceptable Esthetic Outcome? A Prospective Observational Clinical Study

“…The orbital bones protect the globe of the eye, as well as other periocular contents. 1,2 They also present a physical barrier to blunt trauma to the eye, as they protect the globe and the visual apparatus from the effects of orbital blowout fractures, [3][4][5] as well as from high-energy/high-impact injuries to the periorbital region, as there is a high degree of sparing of the optic nerves, globes, and viscera, with low rates of vision loss, ranging from 0.8% to 9%. 6 Connective tissue structures within the orbit aid in support…”

“…1 Nowadays, in an imitation to follow the demands of the patients esthetically and socially, the traditional staged method often lost its dominance and was replaced by a faster 1-step surgical protocol. 2 Regarding the timing of implant placement, 4 types are classified depending on the clinical outcomes of wound healing. 3 This classification was slightly altered in 2008 by Chen and Buser, 4 and comprises:…”