Abstract：
OBJECTIVE: To systematically assess the literature and report on (1) the frequency of occurrence of buccal soft tissue dehiscence (BSTD) at implants, (2) factors associated with the occurrence of BSTD and (3) treatment outcomes of reconstructive therapy for the coverage of BSTD.
METHODS: Two systematic reviews addressing focused questions related to implant BSTD occurrence, associated factors and the treatment outcomes of BSTD coverage served as the basis for group discussions and the consensus statements. The main findings of the systematic reviews, consensus statements and implications for clinical practice and for future research were formulated within group 3 and were further discussed and reached final approval within the plenary session.
RESULTS: Buccally positioned implants were the factor most strongly associated with the risk of occurrence of BSTD, followed by thin tissue phenotype. At immediate implants, it was identified that the use of a connective tissue graft (CTG) may act as a protective factor for BSTD. Coverage of BSTD may be achieved with a combination of a coronally advanced flap (CAF) and a connective tissue graft, with or without prosthesis modification/removal, although feasibility of the procedure depends upon multiple local and patient-related factors. Soft tissue substitutes showed limited BSTD coverage.
CONCLUSIONS: Correct three-dimensional (3D) positioning of the implant is of utmost relevance to prevent the occurrence of BSTD. If present, BSTD may be covered by CAF +CTG, however the evidence comes from a low number of observational studies. Therefore, future research is needed for the development of further evidence-based clinical recommendations.
METHODS: Two systematic reviews addressing focused questions related to implant BSTD occurrence, associated factors and the treatment outcomes of BSTD coverage served as the basis for group discussions and the consensus statements. The main findings of the systematic reviews, consensus statements and implications for clinical practice and for future research were formulated within group 3 and were further discussed and reached final approval within the plenary session.
RESULTS: Buccally positioned implants were the factor most strongly associated with the risk of occurrence of BSTD, followed by thin tissue phenotype. At immediate implants, it was identified that the use of a connective tissue graft (CTG) may act as a protective factor for BSTD. Coverage of BSTD may be achieved with a combination of a coronally advanced flap (CAF) and a connective tissue graft, with or without prosthesis modification/removal, although feasibility of the procedure depends upon multiple local and patient-related factors. Soft tissue substitutes showed limited BSTD coverage.
CONCLUSIONS: Correct three-dimensional (3D) positioning of the implant is of utmost relevance to prevent the occurrence of BSTD. If present, BSTD may be covered by CAF +CTG, however the evidence comes from a low number of observational studies. Therefore, future research is needed for the development of further evidence-based clinical recommendations.
摘要：
目的：系统评估文献和报告（1）种植体口腔软组织裂开（BSTD）的发生频率，（2）与BSTD发生相关的因素和（3）BSTD覆盖率重建治疗的治疗结果。
方法：两项系统综述，涉及与植入物BSTD发生有关的重点问题，相关因素和BSTD覆盖的治疗结局是小组讨论和共识声明的基础.系统综述的主要发现，在第3组中制定了共识声明和对临床实践和未来研究的影响，并在全体会议上进行了进一步讨论并获得最终批准。
结果：与BSTD发生风险密切相关的因素是，其次是薄组织表型。在立即植入时，发现使用结缔组织移植物(CTG)可能是BSTD的保护因素.BSTD的覆盖可以通过冠状推进皮瓣（CAF）和结缔组织移植物的组合来实现，有或没有假体修改/移除，虽然手术的可行性取决于多个局部因素和患者相关因素。软组织替代品显示BSTD覆盖率有限。
结论：正确的植入物三维（3D）定位对于预防BSTD的发生至关重要。如果存在，BSTD可由CAF+CTG覆盖,然而，证据来自少量的观察性研究。因此,未来的研究需要制定进一步的循证临床建议.
方法：两项系统综述，涉及与植入物BSTD发生有关的重点问题，相关因素和BSTD覆盖的治疗结局是小组讨论和共识声明的基础.系统综述的主要发现，在第3组中制定了共识声明和对临床实践和未来研究的影响，并在全体会议上进行了进一步讨论并获得最终批准。
结果：与BSTD发生风险密切相关的因素是，其次是薄组织表型。在立即植入时，发现使用结缔组织移植物(CTG)可能是BSTD的保护因素.BSTD的覆盖可以通过冠状推进皮瓣（CAF）和结缔组织移植物的组合来实现，有或没有假体修改/移除，虽然手术的可行性取决于多个局部因素和患者相关因素。软组织替代品显示BSTD覆盖率有限。
结论：正确的植入物三维（3D）定位对于预防BSTD的发生至关重要。如果存在，BSTD可由CAF+CTG覆盖,然而，证据来自少量的观察性研究。因此,未来的研究需要制定进一步的循证临床建议.
