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

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

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Publication Article, review peer-reviewed scientific
Title Soft tissue substitutes in non-root coverage procedures : a systematic review and meta-analysis
Author Bertl, Kristina ; Melchard, Maximilian ; Pandis, Nikolaos ; Müller-Kern, Michael ; Stavropoulos, Andreas
Date 2017
English abstract
Objectives The present systematic review compared the effec- tiveness of soft tissue substitutes (STSs) and autogenous free gingival grafts (FGGs) in non-root-coverage procedures to increase keratinized tissue (KT) width around teeth. Materials and methods Included studies fulfilled the follow- ing main eligibility criteria: (a) preclinical in vivo or human controlled trials using FGG as control, (b) non-root-coverage procedures, and (c) assessment of KT width. Meta-analysis was performed on the gain in KT width (primary outcome variable) and several secondary variables. Results Eight human trials with short observation time evalu- ating five different STSs were identified. FGG yielded consis- tently significantly (p < 0.001) larger increase in KT width irrespective whether the comparison regarded an acellular ma- trix or a tissue-engineered STS. Further, FGG yielded consis- tently ≥2 mm KT width postoperatively, while use of STS did not, in the few studies reporting on this outcome. On the other hand, STSs resulted in significantly better aesthetic outcomes and received greater patient preference (p < 0.001). Conclusions Based on relatively limited evidence, in non- root-coverage procedures, FGG (1) resulted consistently in significantly larger increase in KT width compared to STS and (2) yielded consistently ≥2 mm KT width postoperatively, while STSs did not. STSs yielded significantly better aesthetic outcomes, received greater patient preference, and appeared safe. Clinical relevance Larger and more predictable increase in KT width is achieved with FGG, but STSs may be considered when aesthetics is important. Clinical studies reporting rele- vant posttreatment outcomes, e.g., postop KT width ≥2 mm, on the long-term (>6 months) are warranted.
DOI https://doi.org/10.1007/s00784-016-2044-4 (link to publisher's fulltext.)
Link http://link.springer.com/article/10.1007/s00784-016-2044-4 .Icon
Publisher Springer
Host/Issue Clinical Oral Investigations;
ISSN 1432-6981
Language eng (iso)
Subject Attached gingiva
Keratinized tissue
Meta-analysis
Randomized controlled trials
Soft tissue augmentation
Systematic review
Medicine
Research Subject Categories::ODONTOLOGY
Handle http://hdl.handle.net/2043/22452 Permalink to this page
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