Ahamed Syed Kowsar, Menchini-Fabris Giovanni Battista, Alqarni Ali, Alarabi Shaimaa Mohammed, Alharbi Abdulaziz Abdullah, Alshamrani Ammar, Covani Ugo, Cosola Saverio
Department of Oral & Maxiloofacial Surgery and Diagnostic Sciences, Faculty of Dentistry, Taif University, Taif 21944, Saudi Arabia.
Department of Stomatology, Tuscan Stomatologic Institute, Foundation for Dental Clinic, Research and Continuing Education, 55041 Camaiore, Italy.
J Clin Med. 2025 May 12;14(10):3351. doi: 10.3390/jcm14103351.
A peri-implant gap or a "jumping gap" between an implant surface and the buccal bone can often complicate the successful integration of dental implants, impairing osseointegration and long-term implant stability. Although various techniques and materials are available for managing this gap, there is no consensus on the most effective approach. The current literature lacks standardized, evidence-based guidelines for selecting the optimal technique or material for managing peri-implant gaps, especially following immediate implant placement. This systematic review aims to evaluate the efficacy of various techniques and materials to manage the peri-implant gap to improve the implant stability, bone preservation, and esthetic outcomes using the PROSPERO registration number CRD42024508852. A comprehensive search of the MEDLINE, Embase, and Cochrane databases was conducted, and various studies were selected, including 11 randomized clinical trials that investigated different grafting materials and techniques for managing the gap between the implant and the buccal plate. The selected studies were assessed for the risk of bias, and the data were extracted based on primary outcomes such as implant stability, bone density, and esthetic parameters. The findings indicate that xenografts and alloplastic grafts were superior in preserving bone volume compared to platelet-rich fibrin. Techniques like the socket shield and immediate provisional prothesis methods showed promise in maintaining soft tissue and bone integrity. However, heterogeneity across the studies limits definitive conclusions. Further high-quality research is needed to establish standardized guidelines for peri-implant gap management. The selection of techniques and materials should be tailored to individual patient needs.
种植体表面与颊侧骨之间的种植体周围间隙或“跳跃间隙”常常会使牙种植体的成功整合变得复杂，损害骨结合以及种植体的长期稳定性。尽管有多种技术和材料可用于处理这个间隙，但对于最有效的方法尚无共识。目前的文献缺乏关于选择用于处理种植体周围间隙的最佳技术或材料的标准化、循证指南，尤其是在即刻种植后。本系统评价旨在使用PROSPERO注册号CRD42024508852评估各种技术和材料处理种植体周围间隙以改善种植体稳定性、骨保存和美学效果的疗效。对MEDLINE、Embase和Cochrane数据库进行了全面检索，并选择了各种研究，包括11项随机临床试验，这些试验研究了用于处理种植体与颊侧板之间间隙的不同移植材料和技术。对所选研究进行偏倚风险评估，并根据种植体稳定性、骨密度和美学参数等主要结局提取数据。研究结果表明，与富血小板纤维蛋白相比，异种移植物和异体移植物在保留骨体积方面更具优势。牙槽窝屏障和即刻临时修复等技术在维持软组织和骨完整性方面显示出前景。然而，研究之间的异质性限制了得出明确结论。需要进一步的高质量研究来建立种植体周围间隙管理的标准化指南。技术和材料的选择应根据个体患者的需求进行调整。
