Alkabazi Malik, Ouakouak Nawel, Aldieb Ebtesam
School of Dentistry, Khalij-Libya, Tripoli, Libya; Tripoli Higher Institute of Medical Sciences, Zliten, Libya.
Faculty of Dentistry, University of Sabha, Sabha, Libya.
J Stomatol Oral Maxillofac Surg. 2025 Sep;126(4S):102371. doi: 10.1016/j.jormas.2025.102371. Epub 2025 Apr 11.
The vertical soft tissue thickness over the implant is essential for long-term procedure success and for biological integration of the suprabony soft tissue component, consequently, development of alternatives to autogenous soft tissue grafts such as allogeneic and xenogeneic grafts were needed. Acellular dermal matrix (ADM) is utilized to provide structural support for angiogenesis, revascularization and tissue remodeling in soft tissue augmentation, recession, and increasing the keratinized tissue width. At this point, the aim of this systematic review was to evaluate the amount of soft tissue height (STH) gained after augmenting the ADM in combination with the dental implants.
A systematic search was performed in five databases. The primary outcome measure was STH change. Secondary outcomes included marginal bone loss (MBL) and pocket probing depth (PPD) at implant sites.
Six studies, with 200 participants, and reported pre- and post-operative mean of vertical tissue thickness, MBL, and PPD around implants were included in the meta-analysis. The pooled mean difference (MD) of STH was 0.84 (95 % CI:0.28 to 1.39) with a p-value < 0.0001. A total of three studies, reported MBL. The pooled MD of MBL around implants, comparing the mean change from baseline to 12 months. The random effect model revealed a MD of 0.07mm (95 % CI: -0.21 to 0.35 mm, p= 0.6325). Calculation of pooled MD of PPD at implant sites, comparing ADM groups to the control groups in three studies; the random effect model revealed a MD of -0.13mm (95 % CI: -0.47 to 0.22 mm, p= 0.4742).
While Acellular dermal matrix significantly improves vertical soft tissue thickness, it does not significantly impact marginal bone loss or pocket probing depth.
种植体上方垂直软组织厚度对于手术的长期成功以及龈上软组织成分的生物整合至关重要，因此，需要开发自体软组织移植的替代方法，如异体和异种移植物。脱细胞真皮基质（ADM）用于在软组织增量、退缩和增加角化组织宽度时为血管生成、血管再通和组织重塑提供结构支持。此时，本系统评价的目的是评估ADM与牙种植体联合应用后获得的软组织高度（STH）量。
在五个数据库中进行了系统检索。主要结局指标是STH变化。次要结局包括种植体部位的边缘骨丢失（MBL）和牙周袋探诊深度（PPD）。
六项研究，共200名参与者，报告了种植体周围垂直组织厚度、MBL和PPD的术前和术后平均值，纳入了荟萃分析。STH的合并平均差（MD）为0.84（95%CI：0.28至1.39），p值<0.0001。共有三项研究报告了MBL。种植体周围MBL的合并MD，比较从基线到12个月的平均变化。随机效应模型显示MD为0.07mm（95%CI：-0.21至0.35mm，p = 0.6325）。在三项研究中计算种植体部位PPD的合并MD，将ADM组与对照组进行比较；随机效应模型显示MD为-0.13mm（95%CI：-0.47至0.22mm，p = 0.4742）。
虽然脱细胞真皮基质显著改善了垂直软组织厚度，但对边缘骨丢失或牙周袋探诊深度没有显著影响。
