Anahita Moscowchi, Reza Amid, Mohammad Nahvi, Nazli Rastkar
{"title":"Timing of keratinized mucosa augmentation and peri-implant outcomes: A systematic review and meta-analysis.","authors":"Anahita Moscowchi, Reza Amid, Mohammad Nahvi, Nazli Rastkar","doi":"10.1111/jopr.14064","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to compare different surgical timings for keratinized mucosa (KM) augmentation and assess the impact on peri-implant parameters stability.</p><p><strong>Methods: </strong>Electronic searches were conducted through MEDLINE (via PubMed), Scopus, Embase, and Web of Science up to June 13, 2024, which was completed with a manual search. The inclusion criteria focused on randomized and non-randomized human clinical studies that assessed outcomes of KM augmentation, with at least 3-months follow-up. The analysis included changes in KM width over time and several secondary outcomes.</p><p><strong>Results: </strong>Twenty-five studies satisfied the inclusion criteria. The studies included 855 patients and 1588 implants. The KM width significantly increased after surgery, regardless of the time or method of intervention (MD: 5.17, 95% CI: 4.59, 5.75, p<0.001). The second-stage surgery, particularly with the use of autogenous graft, indicated the lowest reduction in KM width up to 3 months after surgery, while a significant shrinkage was found when the augmentation was performed post-restoratively.</p><p><strong>Conclusion: </strong>The evidence suggests that second-stage surgery is acceptable for KM augmentation, whereas the post-restorative phase is generally not the primary option. In cases where suboptimal soft tissue conditions are detected, it is advisable to either undertake KM augmentation or refer the patient for additional assessment before proceeding with the delivery of the restoration. Due to limited data, it is not possible to come to a definitive conclusion about the other surgical phases.</p>","PeriodicalId":49152,"journal":{"name":"Journal of Prosthodontics-Implant Esthetic and Reconstructive Dentistry","volume":" ","pages":""},"PeriodicalIF":3.4000,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Prosthodontics-Implant Esthetic and Reconstructive Dentistry","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/jopr.14064","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"DENTISTRY, ORAL SURGERY & MEDICINE","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: This study aimed to compare different surgical timings for keratinized mucosa (KM) augmentation and assess the impact on peri-implant parameters stability.
Methods: Electronic searches were conducted through MEDLINE (via PubMed), Scopus, Embase, and Web of Science up to June 13, 2024, which was completed with a manual search. The inclusion criteria focused on randomized and non-randomized human clinical studies that assessed outcomes of KM augmentation, with at least 3-months follow-up. The analysis included changes in KM width over time and several secondary outcomes.
Results: Twenty-five studies satisfied the inclusion criteria. The studies included 855 patients and 1588 implants. The KM width significantly increased after surgery, regardless of the time or method of intervention (MD: 5.17, 95% CI: 4.59, 5.75, p<0.001). The second-stage surgery, particularly with the use of autogenous graft, indicated the lowest reduction in KM width up to 3 months after surgery, while a significant shrinkage was found when the augmentation was performed post-restoratively.
Conclusion: The evidence suggests that second-stage surgery is acceptable for KM augmentation, whereas the post-restorative phase is generally not the primary option. In cases where suboptimal soft tissue conditions are detected, it is advisable to either undertake KM augmentation or refer the patient for additional assessment before proceeding with the delivery of the restoration. Due to limited data, it is not possible to come to a definitive conclusion about the other surgical phases.
期刊介绍:
The Journal of Prosthodontics promotes the advanced study and practice of prosthodontics, implant, esthetic, and reconstructive dentistry. It is the official journal of the American College of Prosthodontists, the American Dental Association-recognized voice of the Specialty of Prosthodontics. The journal publishes evidence-based original scientific articles presenting information that is relevant and useful to prosthodontists. Additionally, it publishes reports of innovative techniques, new instructional methodologies, and instructive clinical reports with an interdisciplinary flair. The journal is particularly focused on promoting the study and use of cutting-edge technology and positioning prosthodontists as the early-adopters of new technology in the dental community.