Abstract：
OBJECTIVE: The primary objective of this review is to compare autogenous soft tissue grafts (connective tissue graft - CTG and free gingival graft-FGG) with different type of matrices (acellular dermal matrix-ADM, xenograft collagen matrix-XCM, volume-stable collagen matrix-VCMX) used to increase peri-implant soft tissues.
METHODS: A search on electronic databases was performed to identify randomized and non-randomized controlled trials (RCTs and CCTs, respectively) with either parallel or split-mouth design, and treating ≥ 10 patients. A network meta-analysis (NMA) was used to compare different matrices. Soft tissue thickness dimensional changes and keratinized width (KMW) changes were the primary outcome measures. The secondary outcomes were to evaluate: a) PROMs; b) volumetric changes; c) surgical operating time; and d) different periodontal measurements.
RESULTS: A total of 23 studies were included in the qualitative analysis, and 16 studies (11 RCTs and 5 CCTs) in the quantitative analysis. A total of N = 573 sites were evaluated for NMA. CTG resulted the best material for increasing peri-implant soft tissue thickness, at 180 and 360 days after surgery. The use of an ADM showed good results for buccal thickness increase, primarily in the first three months after surgery. Vestibuloplasty + FGG resulted in the most effective technique for peri-implant KMW augmentation, after 180 days.
CONCLUSIONS: While CTG demonstrated better performance in all the comparison and FGG showed to be the best graft to increase keratinized mucosa up to 90 days, ADM and VCMX may be used to increase soft tissue horizontal thickness with lower patients\' morbidity.
CONCLUSIONS: The limits of this NMA are the following: a) limited number of included studies; b) high heterogeneity among them (number of patients, treatment sites, surgical techniques, outcome measures, and follow-ups).
CONCLUSIONS: Many studies compared the efficacy of autogenous and non-autogenous grafts in terms of gingival thickness, volume, and keratinized width increase. However, there is still not clear overall evidence on this topic. This NMA helps clinicians to choose the right material in different peri-implant soft tissue procedures. Recommendations for future studies are mandatory.
METHODS: A search on electronic databases was performed to identify randomized and non-randomized controlled trials (RCTs and CCTs, respectively) with either parallel or split-mouth design, and treating ≥ 10 patients. A network meta-analysis (NMA) was used to compare different matrices. Soft tissue thickness dimensional changes and keratinized width (KMW) changes were the primary outcome measures. The secondary outcomes were to evaluate: a) PROMs; b) volumetric changes; c) surgical operating time; and d) different periodontal measurements.
RESULTS: A total of 23 studies were included in the qualitative analysis, and 16 studies (11 RCTs and 5 CCTs) in the quantitative analysis. A total of N = 573 sites were evaluated for NMA. CTG resulted the best material for increasing peri-implant soft tissue thickness, at 180 and 360 days after surgery. The use of an ADM showed good results for buccal thickness increase, primarily in the first three months after surgery. Vestibuloplasty + FGG resulted in the most effective technique for peri-implant KMW augmentation, after 180 days.
CONCLUSIONS: While CTG demonstrated better performance in all the comparison and FGG showed to be the best graft to increase keratinized mucosa up to 90 days, ADM and VCMX may be used to increase soft tissue horizontal thickness with lower patients\' morbidity.
CONCLUSIONS: The limits of this NMA are the following: a) limited number of included studies; b) high heterogeneity among them (number of patients, treatment sites, surgical techniques, outcome measures, and follow-ups).
CONCLUSIONS: Many studies compared the efficacy of autogenous and non-autogenous grafts in terms of gingival thickness, volume, and keratinized width increase. However, there is still not clear overall evidence on this topic. This NMA helps clinicians to choose the right material in different peri-implant soft tissue procedures. Recommendations for future studies are mandatory.
摘要：
目的：本综述的主要目的是比较自体软组织移植物（结缔组织移植物-CTG和游离牙龈移植物-FGG）与不同类型的基质（无细胞真皮基质-ADM，异种移植胶原基质-XCM,体积稳定的胶原基质-VCMX）用于增加植入物周围的软组织。
方法：对电子数据库进行搜索，以确定随机和非随机对照试验（RCT和CCT，分别)具有平行或分口设计，治疗≥10名患者。网络荟萃分析(NMA)用于比较不同的矩阵。软组织厚度尺寸变化和角化宽度（KMW）变化是主要结果指标。次要结果是评估：a）PROM；b）体积变化；c）外科手术时间；和d）不同的牙周测量。
结果：共23项研究纳入定性分析，定量分析中的16项研究(11项RCT和5项CCT)。针对NMA评估了总共N=573个位点。CTG是增加种植体周围软组织厚度的最佳材料，在手术后180和360天。使用ADM显示出口腔厚度增加的良好结果，主要是在手术后的前三个月。前庭成形术+FGG导致最有效的植入物周围KMW增强技术，180天后。
结论：虽然CTG在所有比较中显示出更好的性能，而FGG显示出最佳的移植物，以增加角化粘膜长达90天，ADM和VCMX可用于增加软组织水平厚度，降低患者发病率。
结论：该NMA的限制如下：a）纳入研究的数量有限；b）它们之间的高度异质性（患者人数，治疗部位,外科技术,结果衡量标准，和后续行动)。
结论：许多研究比较了自体和非自体移植在牙龈厚度方面的疗效，volume,角化宽度增加。然而,关于这个主题仍然没有明确的总体证据。这种NMA帮助临床医生在不同的种植体周围软组织手术中选择正确的材料。未来研究的建议是强制性的。
方法：对电子数据库进行搜索，以确定随机和非随机对照试验（RCT和CCT，分别)具有平行或分口设计，治疗≥10名患者。网络荟萃分析(NMA)用于比较不同的矩阵。软组织厚度尺寸变化和角化宽度（KMW）变化是主要结果指标。次要结果是评估：a）PROM；b）体积变化；c）外科手术时间；和d）不同的牙周测量。
结果：共23项研究纳入定性分析，定量分析中的16项研究(11项RCT和5项CCT)。针对NMA评估了总共N=573个位点。CTG是增加种植体周围软组织厚度的最佳材料，在手术后180和360天。使用ADM显示出口腔厚度增加的良好结果，主要是在手术后的前三个月。前庭成形术+FGG导致最有效的植入物周围KMW增强技术，180天后。
结论：虽然CTG在所有比较中显示出更好的性能，而FGG显示出最佳的移植物，以增加角化粘膜长达90天，ADM和VCMX可用于增加软组织水平厚度，降低患者发病率。
结论：该NMA的限制如下：a）纳入研究的数量有限；b）它们之间的高度异质性（患者人数，治疗部位,外科技术,结果衡量标准，和后续行动)。
结论：许多研究比较了自体和非自体移植在牙龈厚度方面的疗效，volume,角化宽度增加。然而,关于这个主题仍然没有明确的总体证据。这种NMA帮助临床医生在不同的种植体周围软组织手术中选择正确的材料。未来研究的建议是强制性的。
