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Soft tissue substitutes in non-root coverage procedures: a systematic review and meta-analysis

OBJECTIVES: 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. MATERIALS AND METHODS: Included studies fulfilled the following ma...

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Autores principales: Bertl, Kristina, Melchard, Maximilian, Pandis, Nikolaos, Müller-Kern, Michael, Stavropoulos, Andreas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5318480/
https://www.ncbi.nlm.nih.gov/pubmed/28108833
http://dx.doi.org/10.1007/s00784-016-2044-4
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author Bertl, Kristina
Melchard, Maximilian
Pandis, Nikolaos
Müller-Kern, Michael
Stavropoulos, Andreas
author_facet Bertl, Kristina
Melchard, Maximilian
Pandis, Nikolaos
Müller-Kern, Michael
Stavropoulos, Andreas
author_sort Bertl, Kristina
collection PubMed
description OBJECTIVES: 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. MATERIALS AND METHODS: 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. RESULTS: Eight human trials with short observation time evaluating five different STSs were identified. FGG yielded consistently significantly (p < 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 (p < 0.001). CONCLUSIONS: 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. CLINICAL RELEVANCE: 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. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s00784-016-2044-4) contains supplementary material, which is available to authorized users.
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spelling pubmed-53184802017-03-06 Soft tissue substitutes in non-root coverage procedures: a systematic review and meta-analysis Bertl, Kristina Melchard, Maximilian Pandis, Nikolaos Müller-Kern, Michael Stavropoulos, Andreas Clin Oral Investig Review OBJECTIVES: 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. MATERIALS AND METHODS: 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. RESULTS: Eight human trials with short observation time evaluating five different STSs were identified. FGG yielded consistently significantly (p < 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 (p < 0.001). CONCLUSIONS: 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. CLINICAL RELEVANCE: 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. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s00784-016-2044-4) contains supplementary material, which is available to authorized users. Springer Berlin Heidelberg 2017-01-20 2017 /pmc/articles/PMC5318480/ /pubmed/28108833 http://dx.doi.org/10.1007/s00784-016-2044-4 Text en © The Author(s) 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Review
Bertl, Kristina
Melchard, Maximilian
Pandis, Nikolaos
Müller-Kern, Michael
Stavropoulos, Andreas
Soft tissue substitutes in non-root coverage procedures: a systematic review and meta-analysis
title Soft tissue substitutes in non-root coverage procedures: a systematic review and meta-analysis
title_full Soft tissue substitutes in non-root coverage procedures: a systematic review and meta-analysis
title_fullStr Soft tissue substitutes in non-root coverage procedures: a systematic review and meta-analysis
title_full_unstemmed Soft tissue substitutes in non-root coverage procedures: a systematic review and meta-analysis
title_short Soft tissue substitutes in non-root coverage procedures: a systematic review and meta-analysis
title_sort soft tissue substitutes in non-root coverage procedures: a systematic review and meta-analysis
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5318480/
https://www.ncbi.nlm.nih.gov/pubmed/28108833
http://dx.doi.org/10.1007/s00784-016-2044-4
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