Header

UZH-Logo

Maintenance Infos

A systematic review assessing soft tissue augmentation techniques


Thoma, D S; Benić, G I; Zwahlen, M; Hämmerle, C H F; Jung, R E (2009). A systematic review assessing soft tissue augmentation techniques. Clinical Oral Implants Research, 20(Suppl.):146-165.

Abstract

Aim: The aim of the present review was to systematically assess the dental literature in terms of soft tissue grafting techniques. The focused question was: is there superiority of one method over others for augmentation and stability of the augmented soft tissue in terms of increasing the width of keratinized tissue (part 1), and gain in soft tissue volume (part 2).
Methods: A Medline search was performed for human studies focusing on augmentation of keratinized tissue and/or soft tissue volume, and complimented by additional hand searching. Relevant studies were identified and statistical results reported for meta-analyses including the test minus control weighted mean differences (WMD) with 95% confidence intervals (CI), the I-squared statistic for tests of heterogeneity, and the number of significant studies.
Results: Twenty-five (part 1) and three (part 2) studies met the inclusion criteria; 14 studies (part 1) were eligible for comparison using meta-analyses. An apically positioned flap/vestibuloplasty (APF/V) procedure resulted in a statistically significantly greater gain in keratinized tissue than untreated controls. APF/V plus autogenous tissue revealed statistically significant more attached gingiva compared to untreated controls and a borderline statistical significance compared to APF/V plus allogenic tissue. Statistically significantly more shrinkage was observed for APF/V plus allogenic graft compared to APF/V plus autogenous tissue. Patient-centered outcomes did not reveal a superiority of any of the treatment methods regarding post-operative complications. The 3 studies reporting on soft tissue volume augmentation could not be compared due to lack of homogeneity. The use of subepithelial connective tissue grafts (SCTGs) resulted in statistically significantly more soft tissue volume gain compared to free gingival grafts (FGGs).
Conclusions: APF/V is a successful treatment concept to increase the width of keratinized tissue or attached gingiva around teeth. The addition of autogenous tissue statistically significantly increases the width of attached gingiva. For soft tissue volume augmentation only limited data are available favoring SCTGs over FGG.

Abstract

Aim: The aim of the present review was to systematically assess the dental literature in terms of soft tissue grafting techniques. The focused question was: is there superiority of one method over others for augmentation and stability of the augmented soft tissue in terms of increasing the width of keratinized tissue (part 1), and gain in soft tissue volume (part 2).
Methods: A Medline search was performed for human studies focusing on augmentation of keratinized tissue and/or soft tissue volume, and complimented by additional hand searching. Relevant studies were identified and statistical results reported for meta-analyses including the test minus control weighted mean differences (WMD) with 95% confidence intervals (CI), the I-squared statistic for tests of heterogeneity, and the number of significant studies.
Results: Twenty-five (part 1) and three (part 2) studies met the inclusion criteria; 14 studies (part 1) were eligible for comparison using meta-analyses. An apically positioned flap/vestibuloplasty (APF/V) procedure resulted in a statistically significantly greater gain in keratinized tissue than untreated controls. APF/V plus autogenous tissue revealed statistically significant more attached gingiva compared to untreated controls and a borderline statistical significance compared to APF/V plus allogenic tissue. Statistically significantly more shrinkage was observed for APF/V plus allogenic graft compared to APF/V plus autogenous tissue. Patient-centered outcomes did not reveal a superiority of any of the treatment methods regarding post-operative complications. The 3 studies reporting on soft tissue volume augmentation could not be compared due to lack of homogeneity. The use of subepithelial connective tissue grafts (SCTGs) resulted in statistically significantly more soft tissue volume gain compared to free gingival grafts (FGGs).
Conclusions: APF/V is a successful treatment concept to increase the width of keratinized tissue or attached gingiva around teeth. The addition of autogenous tissue statistically significantly increases the width of attached gingiva. For soft tissue volume augmentation only limited data are available favoring SCTGs over FGG.

Statistics

Citations

86 citations in Web of Science®
98 citations in Scopus®
Google Scholar™

Altmetrics

Downloads

526 downloads since deposited on 10 Dec 2009
36 downloads since 12 months
Detailed statistics

Additional indexing

Item Type:Journal Article, refereed, further contribution
Communities & Collections:04 Faculty of Medicine > Center for Dental Medicine > Clinic for Fixed and Removable Prosthodontics
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:September 2009
Deposited On:10 Dec 2009 09:32
Last Modified:05 Apr 2016 13:37
Publisher:Wiley-Blackwell
ISSN:0905-7161
Publisher DOI:https://doi.org/10.1111/j.1600-0501.2009.01784.x
PubMed ID:19663961

Download

Preview Icon on Download
Preview
Content: Accepted Version
Filetype: PDF
Size: 1MB
View at publisher

TrendTerms

TrendTerms displays relevant terms of the abstract of this publication and related documents on a map. The terms and their relations were extracted from ZORA using word statistics. Their timelines are taken from ZORA as well. The bubble size of a term is proportional to the number of documents where the term occurs. Red, orange, yellow and green colors are used for terms that occur in the current document; red indicates high interlinkedness of a term with other terms, orange, yellow and green decreasing interlinkedness. Blue is used for terms that have a relation with the terms in this document, but occur in other documents.
You can navigate and zoom the map. Mouse-hovering a term displays its timeline, clicking it yields the associated documents.

Author Collaborations