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Soft tissue augmentation procedures at second-stage surgery: a systematic review.

Renzo G Bassetti1, Alexandra Stähli2, Mario A Bassetti2

  • 1Department of Oral and Maxillofacial Surgery, Lucerne Cantonal Hospital, Spitalstrasse, 6000, Lucerne, Switzerland. renzo.bassetti@luks.ch.

Clinical Oral Investigations
|April 5, 2016
PubMed
Summary
This summary is machine-generated.

This systematic review evaluated soft tissue augmentation methods for dental implants. Apically positioned partial-thickness flaps with free gingival grafts or xenogeneic materials were most effective for increasing keratinized tissue width.

Keywords:
Peri-implant keratinized mucosaPeri-implant soft tissue volumeRe-entrySecond-stage surgery

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Area of Science:

  • Dental Implantology
  • Periodontology
  • Oral Surgery

Background:

  • Soft tissue augmentation is crucial for peri-implant health and aesthetics.
  • Second-stage surgery offers an opportunity to enhance soft tissues around implants.
  • Limited evidence exists comparing different augmentation techniques.

Purpose of the Study:

  • To systematically review and evaluate the efficacy of various soft tissue augmentation methods.
  • To assess the increase in keratinized mucosa width and soft tissue volume during second-stage surgery.
  • To identify the most effective techniques for peri-implant soft tissue enhancement.

Main Methods:

  • Systematic review of MEDLINE (PubMed) and EMBASE (OVID) databases, plus hand search.
  • Inclusion of human studies on soft tissue augmentation around implants during second-stage surgery up to July 2015.
  • Quality assessment using the Cochrane collaboration's tool for risk of bias.

Main Results:

  • Eight prospective studies and two case series were included, all with high risk of bias.
  • Keratinized tissue enlargement ranged from -0.20 to 9.35 mm, depending on technique and material.
  • Apically positioned partial-thickness flap/vestibuloplasty with free gingival graft or xenogeneic graft material showed the most significant keratinized tissue increase.

Conclusions:

  • Apically positioned partial-thickness flap/vestibuloplasty with free gingival graft or xenogeneic graft material provides acceptable outcomes for increasing peri-implant keratinized mucosa.
  • Roll envelope flap or apically positioned partial-thickness flap with subepithelial connective tissue graft are reliable options for augmenting soft tissue volume.
  • Treatment decisions should consider jaw localization and the specific clinical situation.