PDF(Pubmed)
Abstract：
OBJECTIVE: There is a growing evidence to suggest augmenting peri-implant keratinized mucosa in the presence of ≤ 2 mm of keratinized mucosa. However, the most appropriate surgical technique and augmentation materials have yet to be defined. The aim of this systematic review and meta-analyses was to evaluate the clinical and patient-reported outcomes of augmenting keratinized mucosa around implants using free gingival graft (FGG) versus xenogeneic collagen matrix (XCM) before commencing prosthetic implant treatment.
METHODS: Electronic databases were searched to identify observational studies comparing implant sites augmented with FGG to those augmented with XCM. The risk of bias was assessed using the Cochrane Collaboration\'s Risk of Bias tool.
RESULTS: Six studies with 174 participants were included in the present review. Of these, 87 participants had FGG, whereas the remaining participants had XCM. At 6 months, sites augmented with FGG were associated with less changes in the gained width of peri-implant keratinized mucosa compared to those augmented with XCM (mean difference 1.06; 95% confidence interval -0.01 to 2.13; p = 0.05). The difference, however, was marginally significant. The difference between the two groups in changes in thickness of peri-implant keratinized mucosa at 6 months was statistically significantly in favor of FGG. On the other hand, XCM had significantly shorter surgical time, lower postoperative pain score, and higher color match compared to FGG.
CONCLUSIONS: Within the limitation of this review, the augmentation of keratinized mucosa using FGG before the placement of the final prosthesis may have short-term positive effects on soft tissue thickness. XCM might be considered in aesthetically demanding implant sites and where patient comfort or shorter surgical time is a priority. The evidence support, however, is of low to moderate certainty; therefore, further studies are needed to support the findings of the present review.
METHODS: Electronic databases were searched to identify observational studies comparing implant sites augmented with FGG to those augmented with XCM. The risk of bias was assessed using the Cochrane Collaboration\'s Risk of Bias tool.
RESULTS: Six studies with 174 participants were included in the present review. Of these, 87 participants had FGG, whereas the remaining participants had XCM. At 6 months, sites augmented with FGG were associated with less changes in the gained width of peri-implant keratinized mucosa compared to those augmented with XCM (mean difference 1.06; 95% confidence interval -0.01 to 2.13; p = 0.05). The difference, however, was marginally significant. The difference between the two groups in changes in thickness of peri-implant keratinized mucosa at 6 months was statistically significantly in favor of FGG. On the other hand, XCM had significantly shorter surgical time, lower postoperative pain score, and higher color match compared to FGG.
CONCLUSIONS: Within the limitation of this review, the augmentation of keratinized mucosa using FGG before the placement of the final prosthesis may have short-term positive effects on soft tissue thickness. XCM might be considered in aesthetically demanding implant sites and where patient comfort or shorter surgical time is a priority. The evidence support, however, is of low to moderate certainty; therefore, further studies are needed to support the findings of the present review.
摘要：
目的：越来越多的证据表明，在角化粘膜≤2mm的情况下，种植体周围的角化粘膜会增加。然而,最合适的手术技术和增强材料尚未确定。这项系统评价和荟萃分析的目的是评估在开始假体植入物治疗之前，使用游离牙龈移植物（FGG）与异种胶原基质（XCM）增强植入物周围角化粘膜的临床和患者报告的结果。
方法：搜索电子数据库以确定观察性研究，比较用FGG增强的植入部位与用XCM增强的植入部位。使用Cochrane协作的偏差风险工具评估偏差风险。
结果：本综述包括6项研究，包括174名参与者。其中,87名参与者有FGG，而其余参与者有XCM。6个月时,与XCM增强相比,FGG增强部位与种植体周围角化粘膜增加宽度变化较小相关(平均差1.06;95%置信区间-0.01~2.13;p=0.05).的区别,然而,是微不足道的。两组在6个月时种植体周围角化粘膜厚度变化的差异有统计学意义，有利于FGG。另一方面,XCM手术时间明显缩短，术后疼痛评分较低，和更高的颜色匹配相比FGG。
结论：在本综述的范围内，在最终假体放置之前使用FGG增强角化粘膜可能对软组织厚度产生短期积极影响。XCM可能会考虑在美学要求高的植入部位，并且优先考虑患者的舒适度或较短的手术时间。证据支持,然而,具有低至中等的确定性；因此，需要进一步的研究来支持本审查的结果。
方法：搜索电子数据库以确定观察性研究，比较用FGG增强的植入部位与用XCM增强的植入部位。使用Cochrane协作的偏差风险工具评估偏差风险。
结果：本综述包括6项研究，包括174名参与者。其中,87名参与者有FGG，而其余参与者有XCM。6个月时,与XCM增强相比,FGG增强部位与种植体周围角化粘膜增加宽度变化较小相关(平均差1.06;95%置信区间-0.01~2.13;p=0.05).的区别,然而,是微不足道的。两组在6个月时种植体周围角化粘膜厚度变化的差异有统计学意义，有利于FGG。另一方面,XCM手术时间明显缩短，术后疼痛评分较低，和更高的颜色匹配相比FGG。
结论：在本综述的范围内，在最终假体放置之前使用FGG增强角化粘膜可能对软组织厚度产生短期积极影响。XCM可能会考虑在美学要求高的植入部位，并且优先考虑患者的舒适度或较短的手术时间。证据支持,然而,具有低至中等的确定性；因此，需要进一步的研究来支持本审查的结果。
