Azadi Ali, Rezaei Fatemeh, Yazdani Atoosa, Hejazi Kimia, Moallem Savasari Aryousha, Amid Reza, Kadkhodazadeh Mahdi
Dentofacial Deformities Research Center, Research Institute for Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
School of Dentistry, Mazandaran University of Medical Sciences, Sari, Iran.
BMC Oral Health. 2025 Feb 3;25(1):183. doi: 10.1186/s12903-025-05461-0.
The aim of this review is to compare the clinical outcomes of different soft tissue grafting materials (connective tissue graft (CTG), platelet-rich fibrin (L-PRF), allogenic and xenogenic substitutes) applied in immediate implant placement with each other.
Through an electronic search regarding the study's main question ("In patients with non-restorable teeth, who receive immediate dental implants (P), what is the best adjunctive soft tissue grafting approach among different autogenous, allogenous, and xenogenous grafts (I), to achieve the desired hard and soft tissue structure (O), compared to sites without grafting (C)?") in PubMed, Scopus, and ISI Web of Science, randomized controlled clinical trials (RCTs) using different soft tissue grafts were identified and analyzed using a Bayesian random-effect network meta-analysis framework. The pink esthetic score (PES), marginal interproximal bone level changes (MIBL), buccal bone thickness changes (BBT), keratinized tissue width changes (KTW), soft tissue thickness changes (STT), papilla height changes (PH), midfacial gingival margin level changes (MGML) were defined as desired outcomes of the study; except for the MIBL with 12 - 24 months of follow-up, 6 - 12 months is considered for other outcomes.
After duplication removal, 903 studies were identified through the electronic search; from which 21 RCTs were included in the review. Among all comparisons in different outcomes, only CTG demonstrated a significantly higher gain in STT compared to not placing soft tissue graft. However, CTG in MIBL, KTW, STT, PH, and MGML, and uni-layer xenogenic collagen matrix in PES were the superior treatments, according to the treatment ranking based on surface under cumulative ranking (SUCRA).
At the time of immediate implantation, there is no significant difference between different soft tissue grafts regarding the clinical outcomes of implants. However, the utilization of CTG can be suggested in cases with thin soft tissue. The acceptable efficacy of allogenic and xenogenic materials and the non-significant difference between them and CTG indicate supporting evidence for the application of these materials to specific clinical situations simultaneously with immediate implantation.
CRD42024568586.
本综述的目的是比较不同软组织移植材料（结缔组织移植（CTG）、富含血小板纤维蛋白（L-PRF）、同种异体和异种替代物）用于即刻种植时的临床效果。
通过在PubMed、Scopus和ISI Web of Science中对研究的主要问题（“在接受即刻牙种植的不可修复牙齿患者（P）中，与未进行移植的部位相比（C），不同自体、同种异体和异种移植中，哪种最佳辅助软组织移植方法（I）能实现所需的软硬组织结构（O）？”）进行电子检索，确定使用不同软组织移植的随机对照临床试验（RCT），并使用贝叶斯随机效应网络荟萃分析框架进行分析。粉色美学评分（PES）、邻面边缘骨水平变化（MIBL）、颊侧骨厚度变化（BBT）、角化组织宽度变化（KTW）、软组织厚度变化（STT）、乳头高度变化（PH）、面中牙龈边缘水平变化（MGML）被定义为该研究的预期结果；除MIBL随访12 - 24个月外，其他结果考虑随访6 - 12个月。
去除重复后，通过电子检索确定了903项研究；其中21项RCT被纳入本综述。在不同结果的所有比较中，与不进行软组织移植相比，只有CTG在STT方面显示出显著更高的增加。然而，根据累积排名曲线下面积（SUCRA）的治疗排名，CTG在MIBL、KTW、STT、PH和MGML方面，以及单层异种胶原基质在PES方面是更优的治疗方法。
在即刻种植时，不同软组织移植材料在种植体临床效果方面无显著差异。然而，对于软组织薄的病例，可建议使用CTG。同种异体和异种材料的可接受疗效以及它们与CTG之间的无显著差异表明，有证据支持这些材料在即刻种植的同时应用于特定临床情况。
CRD42024568586。
