Increasing the width of keratinized gingiva and soft tissue thickness in the peri-implant area: analytical processing of the data and results obtained from systematic reviews
DOI:
https://doi.org/10.11603/2311-9624.2020.3.11564Keywords:
gingiva, soft tissues, augmentation, peri-implant areaAbstract
Summary. The difference in the structure of soft tissues around dental implants in comparison with the structure of periodontium around teeth, which is determined in particular by the parallel orientation of the fibers relative to the surface of the transmucosal abutment and other characteristics, to some extent reduces the protective potential of peri-implant soft tissue barrier, that in specific clinical conditions and at the corresponding indications substantiates expediency for carrying out various types of augmentation interventions.
The aim of the study – to analyze the data of systematic reviews and associated studies, which highlight the results of increasing the width of keratinized gingiva and soft tissue thickness in the peri-implant area using appropriate methods of intervention and approaches for the target selection of the latter.
Materials and Methods. Due to the objective of the study search was carried out in the Google Scholar search database and the electronic database PubMed, where scientific publications were searched by keywords (“keratinized gingiva”, “keratinized mucosa”, “width”, “soft tissue”, “thickness”, “peri-implant”, “systematic review”, “treatment method”) and Mesh terms respectively (search algorithm: implant [All Fields] AND keratinized [All Fields] AND (“systematic review”[Publication Type] OR “systematic reviews as topic” [MeSH Terms] OR “systematic review” [All Fields]) AND (“therapy” [Subheading] OR “therapy” [All Fields] OR “treatment” [All Fields] OR “therapeutics” [MeSH Terms] OR “therapeutics” [All Fields])).
Results and Discussion. The analysis of systematic reviews confirmed that the success of the performed soft tissue augmentation really depends on the peculiarities of manipulation and the specifics of the materials used. When planning a soft tissue augmentation procedure to increase the width of keratinized gingiva and soft tissue thickness in the peri-implant area, it is advisable to take into account the clinical recommendations of the Osteology Foundation consensus from 2018 and the algorithm for differentiated choice of intervention method proposed by Bassetti.
Conclusions. After processing data obtained from systematic reviews and associated studies, which presented the results of increasing the width of keratinized gums and soft tissue thickness by using different approaches for soft tissue augmentation in the peri-implant area, it was found that the use of apically and coronally displaced flaps respectively in combination with autogenous connective tissue grafts or free gingival grafts characterized by the highest level of long-term outcomes predictability. The data obtained during the analysis is insufficient for statistically argumentation of higher efficiency of one of the analyzed methods compared to others, which is also justified by the heterogeneity of the designs among the all analyzed studies and the use of different types of criteria for assessing keratinized gingiva width and soft tissue thickness increase.
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