Section of Periodontology, Faculty of Medicine and Health Sciences, University Clinic of Dentistry, University of Oviedo, Oviedo, Spain.
Department of Periodontics, Saveetha Institute of Medical and Technical Sciences, Saveetha Dental College and Hospitals, Chennai, India.
Clin Exp Dent Res. 2024 Aug;10(4):e937. doi: 10.1002/cre2.937.
Xenogenic collagen matrices (XCMs) are gaining popularity for soft tissue augmentation in dental implants; yet, gaps exist in our understanding of their comparative effectiveness.
This systematic review and meta-analysis focuses on studies that utilize soft tissue augmentation techniques for dental implants to improve keratinized mucosa width (KMW), soft tissue thickness (STT), and soft tissue volume (STV). We compared porcine collagen matrices with autogenous grafts when no bone grafts were utilized.
We searched databases such as PubMed, Scopus, and the Cochrane Central Register of Controlled Trials for randomized controlled trials and controlled clinical trials published between January 2013 and July 2023 that assessed the efficacy of XCM in peri-implant soft tissue augmentation. The primary outcome included KMW changes while the secondary outcome was STT/STV changes. Statistical analyses were conducted using a random- or fixed-effects model, and heterogeneity was assessed using I statistics.
Nine studies were included in the qualitative analysis, and six were included in the meta-analysis. No significant intergroup differences were observed (p > 0.05), but a significant difference was observed in favor of KMW ≥ 2 mm. Heterogeneity among the studies varied at the 6- and 12-month follow-ups, with I values of 78% and 0%, respectively. The pooled mean difference between the XCM and autograft groups was -0.96 (-1.71 to -0.21), which shows that there was a larger increase in KMW in the autograft group compared with the XCM group (p < 0.05).
Collagen matrices are less effective than autogenous grafts at increasing keratinized tissue and STT/STV, but the two techniques yield comparable aesthetic outcomes. Additional studies are necessary to better guide clinical practice and improve patient outcomes.
异种胶原蛋白基质（XCM）在牙种植体软组织增强方面越来越受欢迎；然而，我们对其相对有效性的理解仍存在差距。
本系统评价和荟萃分析重点研究了用于牙种植体软组织增强的技术，以提高角化黏膜宽度（KMW）、软组织厚度（STT）和软组织体积（STV）。当未使用骨移植物时，我们将猪胶原蛋白基质与自体移植物进行比较。
我们在 PubMed、Scopus 和 Cochrane 中央对照试验注册中心等数据库中搜索了 2013 年 1 月至 2023 年 7 月期间发表的随机对照试验和对照临床试验，评估了 XCM 在种植体周围软组织增强中的疗效。主要结果包括 KMW 的变化，次要结果为 STT/STV 的变化。使用随机或固定效应模型进行统计分析，并使用 I 统计评估异质性。
9 项研究进行了定性分析，6 项研究进行了荟萃分析。组间无显著差异（p>0.05），但在 KMW≥2mm 方面有显著差异。在 6 个月和 12 个月的随访中，研究之间的异质性不同，I 值分别为 78%和 0%。XCM 组和自体移植物组之间的平均差值为-0.96（-1.71 至-0.21），这表明自体移植物组的 KMW 增加幅度大于 XCM 组（p<0.05）。
胶原蛋白基质在增加角化组织和 STT/STV 方面不如自体移植物有效，但这两种技术的美学效果相当。需要进一步的研究来更好地指导临床实践并改善患者的结果。
