Int J Oral Maxillofac Implants. 2013 Nov-Dec;28(6):1536-45. doi: 10.11607/jomi.3244.
The aim of this systematic review was to investigate the effect of keratinized mucosa width (KMW) on clinical parameters of peri-implant health and stability.
Two independent reviewers conducted a comprehensive search to identify studies on human subjects reporting KMW as a bivariate factor (≥ 2 mm and < 2 mm), along with mean pocket depth (PD), bleeding on probing (BOP), modified Bleeding Index (mBI), Gingival Index (GI), Plaque Index (PI), modified PI (mPI), and implant survival with a minimum follow-up of 6 months after implant loading. Eight studies were included in the systematic review and seven in the metaanalyses to ascertain summary effects for differences in the aforementioned parameters among groups of KMW.
Pooled analyses showed that GI, PI, and mPI were significantly higher in the group with KMW of < 2 mm, while mBI was also higher but only marginally significant. In contrast, PD was not significantly different between the two groups. Differences in BOP and implant survival rate could not be analyzed because of limited data availability. Heterogeneity was highly significant among the pooled studies for all investigated variables.
Reduced KMW around implants appears to be associated with clinical parameters indicative of inflammation and poor oral hygiene. However, based on the selected evidence, the predictive value of KMW is limited.
本系统评价旨在研究角化黏膜宽度（KMW）对种植体周围健康和稳定性的临床参数的影响。
两名独立的审查员进行了全面检索，以确定报告 KMW 为双变量因素（≥2mm 和 <2mm）的人类研究，同时报告了平均探诊深度（PD）、探诊出血（BOP）、改良出血指数（mBI）、牙龈指数（GI）、菌斑指数（PI）、改良菌斑指数（mPI）以及种植体在负荷后至少 6 个月的存活率。本系统评价纳入了 8 项研究，荟萃分析纳入了 7 项研究，以确定 KMW 组间上述参数差异的汇总效应。
汇总分析显示，KMW <2mm 组的 GI、PI 和 mPI 显著更高，而 mBI 也更高，但仅略有统计学意义。相比之下，两组间的 PD 无显著差异。由于数据有限，BOP 和种植体存活率的差异无法进行分析。所有研究均存在高度异质性。
种植体周围 KMW 减少似乎与炎症和口腔卫生不良的临床参数有关。但是，基于所选证据，KMW 的预测价值有限。
