29 July 2022

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Soft tissue grafting procedures to improve peri-implant health

Alessandra Abbà

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Placement of dental implants in the correct tridimensional position produces good results that are maintained over time.  However, some esthetic alterations may occur in the hard and soft tissues that compromise the success rate of dental implants. Indeed the alveolar ridge undergoes clinical and biological modifications after tooth extraction that result in soft and hard tissue loss.
Soft tissue grafts may be used to achieve better clinical outcomes, providing a more stable peri-implant mucosa.
Soft tissue grafts are increasingly performed in conjunction with dental implants  therapy for a number of indications that include recession coverage, gain of keratinized tissue(KT), and augmentation of soft tissue volume. 

The objective of this study was to review the literature in terms of soft tissue grafts and their influence on peri-implant health.

Material and Methods
The controlled clinical studies comparing soft tissue grafting versus no soft tissue grafting or two types of soft tissue grafts at implant sites were selected using a MEDLINE search from 1966 to 2016 and an additional hand search. 

Results
 10 study resulted to be suitable for the review according to the inclusion criteria. 

-keratinized tissue: soft tissue grafts for gain of KT showed greater improvement of gingival index values compared to maintenance groups. 
- Graft technique: statistically significant differences were registered in favor of apically positioned flap (APF) plus autogenous grafts versus all control treatments (APF alone; APF plus a collagen matrix; maintenance without intervention) as regard marginal bone levels changes.
-peri-implant health: Soft tissue grafts didn’t show any significant improvement in bleeding indices, but a significantly less marginal bone loss over time was observed compared to sites without grafting.

Conclusions
The present systematic review focused on the influence of soft tissue grafts onperi-implant healthsoft tissue grafts improve peri-implant healthkeratinized tissue and mucosal thickness using autogenous grafts.

For additional information: Effects of soft tissue augmentation procedures on peri-implant health or disease: A systematic review and meta-analysis