BackgroundDifferent procedures were proposed to augment soft tissue around dental implants.ObjectiveAims 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 MethodsManual/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).ResultsFourteen 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 < .00001) in the meta‐analysis for different techniques for augmentation.ConclusionsEven if further studies at low risk of bias are needed, soft tissue augmentation techniques improved quantity and quality of peri‐implant soft tissue. Among the augmentation procedures, CTG was associated to higher STT change compared to XCM.

Background The aim of this long‐term case series was to assess the development/prevalence of non‐carious cervical lesions (NCCLs) at sites that have and have not been treated with gingival augmentation following free gingival graft (FGG). Methods Fifty‐two patients had at least one test and one control site: 1) test site showing absence of attached gingiva (AG) associated with gingival recession (GR) treated with FGG; and 2) contralateral site with or without AG. Patient/tooth/site‐associated variables were recorded for each tooth/site at baseline (T0), 12 months after surgery (T1), during the follow‐up period (T2) (15 to 20 years), and at the end of the follow‐up period (T3) over 25 to 30 years. Mixed‐effects logistic regression was used throughout the study. Results Forty‐nine patients/130 sites were available for analysis at T2 whereas 44 patients/120 sites at T3. Twenty‐two NCCLs >0.5 mm were restored in the test sites and in 35 in the untreated sites. The development of NCCL over time appeared associated with sites with attached KT <2 mm (i.e., odds ratio [OR]: 3.80 [P = 0.045] and 3.47 [P = 0.046], 15‐ to 20‐ and 20‐ to 30‐year follow‐ups, respectively), as well as to teeth presenting a thin/non‐modified periodontal phenotype (i.e., OR: 3.53 [P = 0.037] and 5.51 [P = 0.008], 15‐ to 20‐ and 20‐ to 30‐year follow‐ups, respectively). Conclusions Periodontal phenotype modification achieved by FGG may prevent the development/progression of NCCL. Evidence suggests that the thickness and width of the AG had a direct influence on the need of restoring these lesions during the 25‐ to 30‐year observation period.

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