Efficacy of Acellular dermal matrix simultaneous with implant placement: A systematic review and meta-analysis of clinical trials.

Purpose: The vertical soft tissue thickness over the implant is essential for long-term procedure success and for biological integration of the suprabony soft tissue component, consequently, development of alternatives to autogenous soft tissue grafts such as allogeneic and xenogeneic grafts were needed. Acellular dermal matrix (ADM) is utilized to provide structural support for angiogenesis, revascularization and tissue remodeling in soft tissue augmentation, recession, and increasing the keratinized tissue width. At this point, the aim of this systematic review was to evaluate the amount of soft tissue height (STH) gained after augmenting the ADM in combination with the dental implants.

Methods: A systematic search was performed in five databases. The primary outcome measure was STH change. Secondary outcomes included marginal bone loss (MBL) and pocket probing depth (PPD) at implant sites.

Results: Six studies, with 200 participants, and reported pre- and post-operative mean of vertical tissue thickness, MBL, and PPD around implants were included in the meta-analysis. The pooled mean difference (MD) of STH was 0.84 (95 % CI:0.28 to 1.39) with a p-value < 0.0001. A total of three studies, reported MBL. The pooled MD of MBL around implants, comparing the mean change from baseline to 12 months. The random effect model revealed a MD of 0.07mm (95 % CI: -0.21 to 0.35 mm, p= 0.6325). Calculation of pooled MD of PPD at implant sites, comparing ADM groups to the control groups in three studies; the random effect model revealed a MD of -0.13mm (95 % CI: -0.47 to 0.22 mm, p= 0.4742).

Conclusion: While Acellular dermal matrix significantly improves vertical soft tissue thickness, it does not significantly impact marginal bone loss or pocket probing depth.