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Gingival phenotype modification therapies on natural teeth: A network meta-analysis
Shayan Barootchi1, Lorenzo Tavelli1, Giovanni Zucchelli1,2
1Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA.
Journal of Periodontology
|May 12, 2020
Summary
Gingival phenotype modification therapy significantly enhances gingival thickness (GT) and keratinized tissue (KT) using various graft materials. Autogenous soft tissue grafts (connective tissue graft/free gingival graft) are superior for both GT and KT augmentation.
Area of Science:
- Periodontology
- Regenerative Dentistry
Background:
- The periodontal phenotype, comprising bone morphotype, keratinized tissue (KT), and gingival thickness (GT), influences periodontal health.
- Phenotype modification therapy (PMT) aims to enhance KT and GT, but its long-term effects and comparative efficacy remain unclear.
Purpose of the Study:
- To systematically review and compare the efficacy of different grafting approaches for gingival PMT.
- To assess the impact of PMT on KT and GT augmentation and periodontal health outcomes.
Main Methods:
- A systematic search identified randomized clinical trials (RCTs) evaluating changes in GT and KT.
- A network meta-analysis (NMA) compared various treatment arms, including autogenous, allogenic, and xenogeneic grafts, for root coverage and non-root coverage procedures.
Main Results:
- All investigated techniques significantly increased GT compared to flap alone; CTG and ADM also significantly increased KT in root coverage procedures.
- For non-root coverage procedures, ADM, CM, FGG, and LCC significantly increased KT compared to APF alone.
- Augmented GT was sustained over time, and KT showed incremental increases.
Conclusions:
- Graft materials significantly enhance GT, while CTG and ADM improve KT in root coverage procedures.
- ADM, CM, FGG, and LCC enhance KT in non-root coverage procedures.
- Autogenous soft tissue grafts (CTG/FGG) demonstrated superiority for both GT and KT augmentation.
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