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

• 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.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Odontologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Dentistry (hsv//eng)

Nyckelord

Attached gingiva

Keratinized tissue

Meta-analysis

Randomized controlled trials

Soft tissue augmentation

Systematic review

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