Soft tissue substitutes in non-root coverage procedures: a systematic review and meta-analysis

Area of Science:

• Periodontology
• Dental Materials Science

Background:

• Increasing keratinized tissue (KT) width is crucial in non-root coverage procedures.
• Soft tissue substitutes (STSs) and autogenous free gingival grafts (FGGs) are common materials used for this purpose.
• A comparative analysis of their effectiveness is essential for clinical decision-making.

Purpose of the Study:

• To systematically review and compare the effectiveness of STSs versus FGGs in increasing KT width.
• To evaluate secondary outcomes including aesthetic results and patient preference.

Main Methods:

• Systematic review of human controlled trials with FGG as control.
• Inclusion criteria focused on non-root coverage procedures and KT width assessment.
• Meta-analysis was conducted on KT width gain and other secondary variables.

Main Results:

• FGG consistently demonstrated a significantly larger increase in KT width compared to all evaluated STSs (p < 0.001).
• FGG achieved ≥2 mm KT width postoperatively, while STSs did not in reported cases.
• STSs showed significantly better aesthetic outcomes and higher patient preference (p < 0.001).

Conclusions:

• FGG provides a more predictable and significant increase in KT width for non-root coverage procedures.
• STSs may be a viable option when aesthetic outcomes are prioritized.
• Further long-term clinical studies (>6 months) are needed to validate outcomes, especially postoperative KT width ≥2 mm.