Soft Tissue Substitutes in Periodontal and Peri-Implant Soft Tissue Augmentation: A Systematic Review
Background: Different extracellular matrix (ECM)-based technologies in periodontal and peri-implant soft tissue augmentation have been proposed in the market. The present review compared the efficacy of soft tissue substitutes (STSs) and autogenous free gingival grafts (FGGs) or connective tissue gr...
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| Format: | Article |
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MDPI AG
2024-03-01
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| Online Access: | https://www.mdpi.com/1996-1944/17/5/1221 |
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| author | Roberto Rotundo Gian Luca Pancrazi Alessia Grassi Lara Ceresoli Giovanna Laura Di Domenico Vanessa Bonafede |
| author_facet | Roberto Rotundo Gian Luca Pancrazi Alessia Grassi Lara Ceresoli Giovanna Laura Di Domenico Vanessa Bonafede |
| author_sort | Roberto Rotundo |
| collection | DOAJ |
| description | Background: Different extracellular matrix (ECM)-based technologies in periodontal and peri-implant soft tissue augmentation have been proposed in the market. The present review compared the efficacy of soft tissue substitutes (STSs) and autogenous free gingival grafts (FGGs) or connective tissue grafts (CTGs) in mucogingival procedures to increase keratinized tissue (KT) width around teeth and implants. Methods: Two independent examiners performed an electronic search on MEDLINE and the Cochrane Library based on the following PICOS format: (P) adult patients; (I) soft tissue substitutes and FGGs/CTGs; (C) STSs vs. CTGs; STSs vs. FGGs; STSs vs control; (O) KT width gain; (S) systematic reviews, randomized controlled trials. Studies published before November 2023 were included. Results: Around teeth, all biomaterials showed superior performance compared to a coronally advanced flap (CAF) alone for treating gingival recessions. However, when compared to CTGs, acellular dermal matrices (ADMs) yield the most similar outcomes to the gold standard (CTGs), even though in multiple recessions, CTGs continue to be considered the most favorable approach. The use of STSs (acellular matrix or tissue-engineered) in combination with apically positioned flaps (APF) resulted in significantly less gain in KT width compared to that achieved with FGGs and APFs. Around dental implants, free gingival grafts were deemed more effective than soft tissue substitutes in enhancing keratinized mucosa width. Conclusions: Based on the available evidence, questions remain about the alternative use of soft tissue substitutes for conventional grafting procedures using free gingival grafts or connective tissue grafts around teeth and implants. |
| first_indexed | 2024-04-25T00:25:44Z |
| format | Article |
| id | doaj.art-a05f86fa0a5b49ff897019a17e9e94f6 |
| institution | Directory Open Access Journal |
| issn | 1996-1944 |
| language | English |
| last_indexed | 2024-04-25T00:25:44Z |
| publishDate | 2024-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Materials |
| spelling | doaj.art-a05f86fa0a5b49ff897019a17e9e94f62024-03-12T16:49:42ZengMDPI AGMaterials1996-19442024-03-01175122110.3390/ma17051221Soft Tissue Substitutes in Periodontal and Peri-Implant Soft Tissue Augmentation: A Systematic ReviewRoberto Rotundo0Gian Luca Pancrazi1Alessia Grassi2Lara Ceresoli3Giovanna Laura Di Domenico4Vanessa Bonafede5Periodontology Unit, University Vita-Salute and IRCCS San Raffaele, 20132 Milan, ItalyOral Surgery, University Vita-Salute and IRCCS San Raffaele, 20132 Milan, ItalyOral Surgery, University Vita-Salute and IRCCS San Raffaele, 20132 Milan, ItalyOral Surgery, University Vita-Salute and IRCCS San Raffaele, 20132 Milan, ItalyOral Surgery, University Vita-Salute and IRCCS San Raffaele, 20132 Milan, ItalyPeriodontology Unit, University Vita-Salute and IRCCS San Raffaele, 20132 Milan, ItalyBackground: Different extracellular matrix (ECM)-based technologies in periodontal and peri-implant soft tissue augmentation have been proposed in the market. The present review compared the efficacy of soft tissue substitutes (STSs) and autogenous free gingival grafts (FGGs) or connective tissue grafts (CTGs) in mucogingival procedures to increase keratinized tissue (KT) width around teeth and implants. Methods: Two independent examiners performed an electronic search on MEDLINE and the Cochrane Library based on the following PICOS format: (P) adult patients; (I) soft tissue substitutes and FGGs/CTGs; (C) STSs vs. CTGs; STSs vs. FGGs; STSs vs control; (O) KT width gain; (S) systematic reviews, randomized controlled trials. Studies published before November 2023 were included. Results: Around teeth, all biomaterials showed superior performance compared to a coronally advanced flap (CAF) alone for treating gingival recessions. However, when compared to CTGs, acellular dermal matrices (ADMs) yield the most similar outcomes to the gold standard (CTGs), even though in multiple recessions, CTGs continue to be considered the most favorable approach. The use of STSs (acellular matrix or tissue-engineered) in combination with apically positioned flaps (APF) resulted in significantly less gain in KT width compared to that achieved with FGGs and APFs. Around dental implants, free gingival grafts were deemed more effective than soft tissue substitutes in enhancing keratinized mucosa width. Conclusions: Based on the available evidence, questions remain about the alternative use of soft tissue substitutes for conventional grafting procedures using free gingival grafts or connective tissue grafts around teeth and implants.https://www.mdpi.com/1996-1944/17/5/1221biomaterialsgingival recessionconnective tissue graftfree gingival graftsoft tissue substituteskeratinized tissue |
| spellingShingle | Roberto Rotundo Gian Luca Pancrazi Alessia Grassi Lara Ceresoli Giovanna Laura Di Domenico Vanessa Bonafede Soft Tissue Substitutes in Periodontal and Peri-Implant Soft Tissue Augmentation: A Systematic Review Materials biomaterials gingival recession connective tissue graft free gingival graft soft tissue substitutes keratinized tissue |
| title | Soft Tissue Substitutes in Periodontal and Peri-Implant Soft Tissue Augmentation: A Systematic Review |
| title_full | Soft Tissue Substitutes in Periodontal and Peri-Implant Soft Tissue Augmentation: A Systematic Review |
| title_fullStr | Soft Tissue Substitutes in Periodontal and Peri-Implant Soft Tissue Augmentation: A Systematic Review |
| title_full_unstemmed | Soft Tissue Substitutes in Periodontal and Peri-Implant Soft Tissue Augmentation: A Systematic Review |
| title_short | Soft Tissue Substitutes in Periodontal and Peri-Implant Soft Tissue Augmentation: A Systematic Review |
| title_sort | soft tissue substitutes in periodontal and peri implant soft tissue augmentation a systematic review |
| topic | biomaterials gingival recession connective tissue graft free gingival graft soft tissue substitutes keratinized tissue |
| url | https://www.mdpi.com/1996-1944/17/5/1221 |
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