Surgical procedures for soft tissue augmentation at implant sites. A systematic review and meta-analysis of randomized controlled trials

Abstract

Background: Different procedures were proposed to augment soft tissue around dental implants. Objective: Aims of this Systematic Review (SR) were to evaluate (a) clinical benefit of soft tissue augmentation at implant sites (b) which is the best surgical procedure to augment soft tissue. Materials and Methods: Manual/electronic searches were performed to identify randomized controlled trials (RCTs). Change in keratinized tissue thickness (STT) and height (KT) were primary outcomes. Random effects meta-analyses were performed where suitable and expressed as weighted mean differences (MD) with their associated 95% confidence intervals (CI). Results: Fourteen RCTs accounting for 475 patients and 538 implants were included. Only five studies were judged at low risk of bias. In the single studies, soft augmentation lead to higher STT and KT compared to no augmentation. Considering primary outcomes, connective tissue graft (CTG) was more effective than xenogeneic collagen matrix (XCM) to improve STT (MD: −0.30 mm; 95% CI −0.43; −0.17; P