Linear and profilometric changes of the mucosa following soft tissue augmentation in the zone of aesthetic priority: A systematic review and meta-analysis.

Abstract

OBJECTIVES\nTo assess the outcomes of soft tissue augmentation, in terms of change in level and thickness of mid-buccal mucosa, at implants sites in the zone of the aesthetic priority.\n\n\nMATERIAL AND METHODS\nMEDLINE, EMBASE and Cochrane Central Register of Controlled Trials databases were searched (last search on 1 June 2020). Inclusion criteria were studies reporting outcomes of different materials and timing of grafting in patients undergoing soft tissue augmentation at implant sites in the aesthetic zone with a follow-up of ≥1\xa0year after implant placement. Outcome measures assessed included changes in level and thickness of mid-buccal mucosa, implant survival, peri-implant health and patients satisfaction.\n\n\nRESULTS\nEighteen out of 2,185 articles fulfilled the inclusion criteria. Meta-analysis revealed a significant difference in vertical mid-buccal soft tissue change (0.34\xa0mm, 95% CI: 0.13-0.56, p\xa0=\xa0.002) and mid-buccal mucosa thickness (0.66\xa0mm, 95% CI: 0.35-0.97, p\xa0<\xa0.001) following immediate implant placement in favour of the use of a graft versus no graft. Mean difference in mid-buccal mucosa level following delayed implant placement (0.17\xa0mm, 95% CI: 0.01-0.34, p\xa0=\xa0.042) was also in favour of the use of a graft versus no graft. With regard to mucosa thickness, the use of a graft was not in favour compared with no graft following delayed implant placement (0.22\xa0mm, 95% CI: -0.04-0.47, p\xa0=\xa0.095). Observed changes remained stable in the medium term.\n\n\nCONCLUSION\nSoft tissue augmentation in the zone of the aesthetic priority results in less recession and a thicker mid-buccal mucosa following immediate implant placement and less recession in mid-buccal mucosa following delayed implant placement compared with no graft.