Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Berlin, Germany, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Periodontology Unit, Centre for Host Microbiome Interactions Faculty of Dentistry, Oral and Craniofacial Sciences, King´s College London, King´s College London, London, UK.
Clin Oral Implants Res. 2022 Jun;33 Suppl 23:125-136. doi: 10.1111/clr.13918.
This systematic review evaluated the effectiveness of soft tissue augmentation procedures for complete coverage and mean coverage of buccal soft tissue dehiscence (BSTD) in patients with implant-supported restorations.
Three databases were surveyed for randomized (RCTs), non-randomized controlled clinical trials (CCTs), cohort studies, case-control studies, and case series with a minimum of five patients per control or test group. Studies dealing with soft tissue augmentation procedures to cover BSTD-occurring during implant function and not due to the result of peri-implantitis-were included. Risk of bias was evaluated with RoB 2 or the National Institutes of Health's Quality Assessment. Whenever possible, exploratory meta-analyses were performed to evaluate weighted mean effects (WME) for the different outcomes. The primary outcomes were the percentage of complete coverage and mean coverage of BSTD.
Seven articles were included. Only one study was a RCT, with a high risk of bias. Meta-analyses showed that after 1 year (2 studies, n = 36 patients; WME = 70; 95% confidence interval [CI] = 50; 90; p = .23) as well as after 5 years (3 studies, n = 54 patients; WME = 70; 95%; CI = 60; 80; p = .44), complete coverage of BSTD could be achieved in 70% of the cases.
Based on limited evidence, it can be concluded that BSTD can be substantially reduced with the use of soft tissue augmentation procedures. Further research with comparative trials using larger samples and longer follow-up periods is needed to study the stability of soft tissues in the long term.
本系统评价评估了软组织增量程序对种植体支持修复患者颊侧软组织缺损（BSTD）完全覆盖和平均覆盖的有效性。
本研究对 3 个数据库进行了调查，纳入了随机对照试验（RCT）、非随机对照临床试验（CCT）、队列研究、病例对照研究和病例系列研究，每个对照组或试验组至少有 5 名患者。纳入了涉及软组织增量程序以覆盖在种植体功能期间发生的、而非因种植体周围炎导致的 BSTD 的研究。采用 RoB 2 或美国国立卫生研究院的质量评估来评估偏倚风险。在可能的情况下，进行了探索性荟萃分析，以评估不同结局的加权均数效应（WME）。主要结局是 BSTD 的完全覆盖和平均覆盖百分比。
纳入了 7 篇文章。仅有 1 项研究为 RCT，存在较高的偏倚风险。荟萃分析显示，在 1 年后（2 项研究，n=36 例患者；WME=70；95%置信区间[CI]：50；90；p=0.23）以及 5 年后（3 项研究，n=54 例患者；WME=70；95%CI：60；80；p=0.44），BSTD 的完全覆盖率可达 70%。
基于有限的证据，可以得出结论，使用软组织增量程序可以显著减少 BSTD。需要进一步开展具有更大样本量和更长随访期的比较试验研究，以长期研究软组织的稳定性。
