Department of Neurosciences, School of Dentistry, University of Padova, Via Giustiniani 2, 35100 Padova, Italy.
Periodontology Unit, Department of Biomedical and Neuromotor Sciences, Bologna University, 40126 Bologna, Italy.
Medicina (Kaunas). 2024 Aug 26;60(9):1393. doi: 10.3390/medicina60091393.
: The influence of the quantity and quality of peri-implant soft tissue on implant health and long-term maintenance is controversial. This consensus aimed to assess the importance of peri-implant soft tissue by analyzing four aspects: the role of keratinized mucosa (KM), the efficacy of specific collagen matrix, the influence of abutment material, and soft-tissue thickness. : Active members of the Italian Academy of Osseointegration (IAO) participated in the consensus. Four systematic reviews were conducted, and their results were discussed to provide guidelines on the importance of soft tissue around implants. The first review evaluated the effect of KM on soft-tissue health, peri-implant bone loss, and patient-related variables. The second one analyzed if there was a specific type of matrix that provided better results in terms of peri-implant buccal soft-tissue thickness and keratinized mucosa width compared to autogenous soft-tissue graft. The third review evaluated the influence of different abutment materials on the soft tissues, and the fourth assessed the effect of soft-tissue thickness on peri-implant marginal bone loss (MBL). : The agreements reached by the assembly were as follows: the presence of supra-periosteal keratinized tissue is considered to favorably influence peri-implant health and aesthetics but had no relation to preventing bone crest resorption unrelated to infection. It facilitates patient cleaning around implants and reduces patient-reported pain. The free gingival graft (FGG) is considered the best in terms of supra-periosteal KM increase. Connective tissue grafts (CTG) perform better than volume-stable collagen matrices to increase soft-tissue thickness. Collagen matrices reduce surgical time and patient morbidity and can give better camouflaging. The influence of abutment material (titanium or zirconia) on MBL remains controversial, and no conclusion could be reached on this issue. Peri-implant soft-tissue health and recession seem not to be influenced by abutment material, but data are limited to zirconia and titanium. Although this systematic review highlighted the absence of a correlation between soft-tissue thickness and MBL, the assembly failed to find a consensus on this issue.
: 种植体周围软组织的数量和质量对种植体健康和长期维护的影响存在争议。本共识旨在通过分析四个方面来评估种植体周围软组织的重要性：角化黏膜（KM）的作用、特定胶原基质的效果、基台材料的影响以及软组织厚度。: 意大利骨整合学会（IAO）的活跃成员参与了这项共识。进行了四项系统评价，并对其结果进行了讨论，以提供有关种植体周围软组织重要性的指南。第一项评价了 KM 对软组织健康、种植体周围骨丧失和患者相关变量的影响。第二项分析了是否有一种特定类型的基质，与自体软组织移植物相比，在种植体颊侧软组织厚度和角化黏膜宽度方面提供了更好的结果。第三项评价了不同基台材料对软组织的影响，第四项评估了软组织厚度对种植体边缘骨丧失（MBL）的影响。: 会议达成的共识如下：存在骨膜上的角化组织被认为有利于种植体周围的健康和美观，但与预防与感染无关的牙槽嵴吸收无关。它便于患者对种植体周围进行清洁，并减少患者报告的疼痛。就增加骨膜上 KM 而言，游离龈移植（FGG）被认为是最好的。结缔组织移植（CTG）比体积稳定的胶原基质在增加软组织厚度方面表现更好。胶原基质可减少手术时间和患者发病率，并可提供更好的伪装效果。基台材料（钛或氧化锆）对 MBL 的影响仍存在争议，在这个问题上无法得出结论。种植体周围软组织的健康和退缩似乎不受基台材料的影响，但数据仅限于氧化锆和钛。虽然这项系统评价强调了软组织厚度与 MBL 之间没有相关性，但会议未能就这一问题达成共识。
