Soft tissue augmentation procedures for mucogingival defects in esthetic sites

Area of Science:

• Dental Implantology
• Periodontology
• Esthetic Dentistry

Background:

• Soft tissue deficiencies around maxillary anterior implants pose esthetic challenges.
• Presurgical esthetic risk assessment (ERA) and team-based planning are crucial for successful outcomes.

Purpose of the Study:

• To evaluate the esthetic outcomes of soft tissue procedures in adult patients with maxillary anterior implant soft tissue deficiencies.
• To review the importance of presurgical esthetic risk assessment (ERA) and restorative-driven approaches.

Main Methods:

• Systematic review of Medline database search.
• Screening of 1,532 titles and 351 abstracts, with 123 full-text articles evaluated.
• Grouping of 18 included studies based on peri-implant soft tissue interventions.

Main Results:

• The majority of included studies were case series lacking objective outcomes; only one randomized controlled trial was identified.
• Quantitative analysis and meta-analysis were not feasible due to study limitations.
• Initial positive results from periodontal procedures were often followed by significant post-healing recession.

Conclusions:

• Limited literature supports soft tissue procedures for esthetic outcomes around maxillary anterior implants.
• Existing studies are few, lack long-term follow-up, and are prone to bias.
• The use of ERA is recommended, but findings should be interpreted cautiously due to limited evidence, necessitating further clinical trials.