Soft tissue substitutes in non-root coverage procedures: a systematic review and meta-analysis
Identifieur interne : 000064 ( Main/Exploration ); précédent : 000063; suivant : 000065Soft tissue substitutes in non-root coverage procedures: a systematic review and meta-analysis
Auteurs : Kristina Bertl [Suède, Autriche] ; Maximilian Melchard [Autriche] ; Nikolaos Pandis [Suisse] ; Michael Müller-Kern [Autriche] ; Andreas Stavropoulos [Suède]Source :
- Clinical Oral Investigations [ 1432-6981 ] ; 2017.
Abstract
The present systematic review compared the effectiveness of soft tissue substitutes (STSs) and autogenous free gingival grafts (FGGs) in non-root-coverage procedures to increase keratinized tissue (KT) width around teeth.
Included studies fulfilled the following main eligibility criteria: (a) preclinical in vivo or human controlled trials using FGG as control, (b) non-root-coverage procedures, and (c) assessment of KT width. Meta-analysis was performed on the gain in KT width (primary outcome variable) and several secondary variables.
Eight human trials with short observation time evaluating five different STSs were identified. FGG yielded consistently significantly (
Based on relatively limited evidence, in non-root-coverage procedures, FGG (1) resulted consistently in significantly larger increase in KT width compared to STS and (2) yielded consistently ≥2 mm KT width postoperatively, while STSs did not. STSs yielded significantly better aesthetic outcomes, received greater patient preference, and appeared safe.
Larger and more predictable increase in KT width is achieved with FGG, but STSs may be considered when aesthetics is important. Clinical studies reporting relevant posttreatment outcomes, e.g., postop KT width ≥2 mm, on the long-term (>6 months) are warranted.
The online version of this article (doi:10.1007/s00784-016-2044-4) contains supplementary material, which is available to authorized users.
Url:
DOI: 10.1007/s00784-016-2044-4
PubMed: 28108833
PubMed Central: 5318480
Affiliations:
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Malmö,</institution></institution-wrap>Carl Gustafs väg 34, 20506 Malmö, Sweden</nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea>Carl Gustafs väg 34, 20506 Malmö</wicri:regionArea><wicri:noRegion>20506 Malmö</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff2"><institution-wrap><institution-id institution-id-type="ISNI">0000 0000 9259 8492</institution-id><institution-id institution-id-type="GRID">grid.22937.3d</institution-id><institution>Division of Oral Surgery, School of Dentistry,</institution><institution>Medical University of Vienna,</institution></institution-wrap>Vienna, Austria</nlm:aff><country xml:lang="fr">Autriche</country><wicri:regionArea>Vienna</wicri:regionArea></affiliation></author><author><name sortKey="Melchard, Maximilian" sort="Melchard, Maximilian" uniqKey="Melchard M" first="Maximilian" last="Melchard">Maximilian Melchard</name><affiliation wicri:level="1"><nlm:aff id="Aff2"><institution-wrap><institution-id institution-id-type="ISNI">0000 0000 9259 8492</institution-id><institution-id institution-id-type="GRID">grid.22937.3d</institution-id><institution>Division of Oral Surgery, School of Dentistry,</institution><institution>Medical University of Vienna,</institution></institution-wrap>Vienna, Austria</nlm:aff><country xml:lang="fr">Autriche</country><wicri:regionArea>Vienna</wicri:regionArea></affiliation></author><author><name sortKey="Pandis, Nikolaos" sort="Pandis, Nikolaos" uniqKey="Pandis N" first="Nikolaos" last="Pandis">Nikolaos Pandis</name><affiliation wicri:level="1"><nlm:aff id="Aff3"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 0726 5157</institution-id><institution-id institution-id-type="GRID">grid.5734.5</institution-id><institution>Department of Orthodontics and Dentofacial Orthopedics, Dental School/Medical Faculty,</institution><institution>University of Bern,</institution></institution-wrap>Bern, Switzerland</nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>Bern</wicri:regionArea></affiliation></author><author><name sortKey="Muller Kern, Michael" sort="Muller Kern, Michael" uniqKey="Muller Kern M" first="Michael" last="Müller-Kern">Michael Müller-Kern</name><affiliation wicri:level="1"><nlm:aff id="Aff4"><institution-wrap><institution-id institution-id-type="ISNI">0000 0000 9259 8492</institution-id><institution-id institution-id-type="GRID">grid.22937.3d</institution-id><institution>Division of Conservative Dentistry and Periodontology, School of Dentistry,</institution><institution>Medical University of Vienna,</institution></institution-wrap>Vienna, Austria</nlm:aff><country xml:lang="fr">Autriche</country><wicri:regionArea>Vienna</wicri:regionArea></affiliation></author><author><name sortKey="Stavropoulos, Andreas" sort="Stavropoulos, Andreas" uniqKey="Stavropoulos A" first="Andreas" last="Stavropoulos">Andreas Stavropoulos</name><affiliation wicri:level="1"><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="ISNI">0000 0000 9961 9487</institution-id><institution-id institution-id-type="GRID">grid.32995.34</institution-id><institution>Department of Periodontology, Faculty of Odontology,</institution><institution>University of Malmö,</institution></institution-wrap>Carl Gustafs väg 34, 20506 Malmö, Sweden</nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea>Carl Gustafs väg 34, 20506 Malmö</wicri:regionArea><wicri:noRegion>20506 Malmö</wicri:noRegion></affiliation></author></analytic><series><title level="j">Clinical Oral Investigations</title><idno type="ISSN">1432-6981</idno><idno type="eISSN">1436-3771</idno><imprint><date when="2017">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Objectives</title><p>The present systematic review compared the effectiveness of soft tissue substitutes (STSs) and autogenous free gingival grafts (FGGs) in non-root-coverage procedures to increase keratinized tissue (KT) width around teeth.</p></sec><sec><title>Materials and methods</title><p>Included studies fulfilled the following main eligibility criteria: (a) preclinical in vivo or human controlled trials using FGG as control, (b) non-root-coverage procedures, and (c) assessment of KT width. Meta-analysis was performed on the gain in KT width (primary outcome variable) and several secondary variables.</p></sec><sec><title>Results</title><p>Eight human trials with short observation time evaluating five different STSs were identified. FGG yielded consistently significantly (<italic>p</italic> < 0.001) larger increase in KT width irrespective whether the comparison regarded an acellular matrix or a tissue-engineered STS. Further, FGG yielded consistently ≥2 mm KT width postoperatively, while use of STS did not, in the few studies reporting on this outcome. On the other hand, STSs resulted in significantly better aesthetic outcomes and received greater patient preference (<italic>p</italic> < 0.001).</p></sec><sec><title>Conclusions</title><p>Based on relatively limited evidence, in non-root-coverage procedures, FGG (1) resulted consistently in significantly larger increase in KT width compared to STS and (2) yielded consistently ≥2 mm KT width postoperatively, while STSs did not. STSs yielded significantly better aesthetic outcomes, received greater patient preference, and appeared safe.</p></sec><sec><title>Clinical relevance</title><p>Larger and more predictable increase in KT width is achieved with FGG, but STSs may be considered when aesthetics is important. Clinical studies reporting relevant posttreatment outcomes, e.g., postop KT width ≥2 mm, on the long-term (>6 months) are warranted.</p></sec><sec><title>Electronic supplementary material</title><p>The online version of this article (doi:10.1007/s00784-016-2044-4) contains supplementary material, which is available to authorized users.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Kim, Dm" uniqKey="Kim D">DM Kim</name></author><author><name sortKey="Neiva, R" uniqKey="Neiva R">R Neiva</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Scheyer, Et" uniqKey="Scheyer E">ET Scheyer</name></author><author><name sortKey="Sanz, M" uniqKey="Sanz M">M Sanz</name></author><author><name sortKey="Dibart, S" uniqKey="Dibart S">S Dibart</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Thoma, Ds" uniqKey="Thoma D">DS Thoma</name></author><author><name sortKey="Benic, Gi" 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uniqKey="Sanz M">M Sanz</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Autriche</li><li>Suisse</li><li>Suède</li></country></list><tree><country name="Suède"><noRegion><name sortKey="Bertl, Kristina" sort="Bertl, Kristina" uniqKey="Bertl K" first="Kristina" last="Bertl">Kristina Bertl</name></noRegion><name sortKey="Stavropoulos, Andreas" sort="Stavropoulos, Andreas" uniqKey="Stavropoulos A" first="Andreas" last="Stavropoulos">Andreas Stavropoulos</name></country><country name="Autriche"><noRegion><name sortKey="Bertl, Kristina" sort="Bertl, Kristina" uniqKey="Bertl K" first="Kristina" last="Bertl">Kristina Bertl</name></noRegion><name sortKey="Melchard, Maximilian" sort="Melchard, Maximilian" uniqKey="Melchard M" first="Maximilian" last="Melchard">Maximilian Melchard</name><name sortKey="Muller Kern, Michael" sort="Muller Kern, Michael" uniqKey="Muller Kern M" first="Michael" last="Müller-Kern">Michael Müller-Kern</name></country><country name="Suisse"><noRegion><name sortKey="Pandis, Nikolaos" sort="Pandis, Nikolaos" uniqKey="Pandis N" first="Nikolaos" last="Pandis">Nikolaos Pandis</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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