“…2 . Five [ 15 , 25 , 27 , 28 , 30 ] of the included studies were considered a low risk of bias, one trial [ 26 ] was classified as a moderate risk of bias, and two studies had a high risk of bias [ 29 , 31 ]. Fig.…”
Section: Resultsmentioning
confidence: 99%
“…Meta-analysis of included studies [ 15 , 25 – 28 , 30 , 31 ] revealed that in the CTG group, the pooled mean 3-month soft tissue thickness gain in the buccal subgroup was μ = 1.0704 mm [95% CI: 0.8325 – 1.3084, I 2 = 53.1%]. Heterogeneity has been found in studies.…”
Section: Resultsmentioning
confidence: 99%
“…In order to evaluate the impact and heterogeneity of measurement methods (analog, digital) on soft tissue thickness gain in the studies, a meta-analysis was undertaken, incorporating research studies [ 15 , 25 – 28 , 30 , 31 ]. A meta-analysis revealed that within CTG group, the pooled mean 3-month soft tissue thickness gain in the analog subgroup was μ = 0.9501 mm [95% CI: 0.8668–1.0334, I 2 = 0.0%].…”
Section: Resultsmentioning
confidence: 99%
“…Soft tissues were sutured to the lingual/palatal flap with 5–0/4–0 resorbable sutures Second stage Split-thickness Derma® (Osteobiol, Tecnoss, Coazze, Torino, Italy) Thickness: 2 mm Palate Not reported Thickness: 2 mm Ashurko et.al. 2022 [ 30 ] Incision: crestal incision with a periostotomy was performed from the buccal side CTG: graft was harvested from tuber area of the upper jaw using a double incision technique XCM: the collagen matrix was modeled according to the shape of the recipient bed The XCM/SCTG was positioned with overlapping the alveolar ridge under flaps from the occlusal and buccal sides. Fixation was performed to the buccal and oral flap using mattress (horizontal) suture During implant surgery Full-thickness FibroMATRIX ® (LLC “Cardioplant”, Russia) Thickness: 1.5 mm Volume: 572.3 ± 166 mm 3 Tuber Double incision technique Thickness: 1.5 mm Hélio et al 2019 [ 31 ] Incision: standard crestal incision CTG: a mucotome with 8 mm in diameter and marking 4 mm of depth was used for graft harvesting XCM: the size of matrix was the same with CTG CTG/XCM were fixed by two simple sutures with mononylon 5.0, one to vestibular flap and the other to lingual flap.…”
Section: Methodsmentioning
confidence: 99%
“…The only significant difference in interdental papilla index was between CTG and No graft group BL—no statistically significant difference None Baseline 2.00 ± 1.2 3.87 ± 1.1 1.84 ± 1.0 1.5 months 2.80 ± 1.2 4.66 ± 0.5 2.00 ± 1.0 6 months 3.05 ± 1.3 4.91 ± 0.8 2.08 ± 1.2 Changes 1.5 months 0.08 ± 0.36 (SE) 0.5 ± 0.56 (SE) 0.08 ± 0.31 (SE) Changes 6 months 1.05 ± 0.35 (SE) 0.8 ± 0.67 (SE) 0.16 ± 0.45 (SE) Ashurko et.al. 2022 [ 30 ] No significant difference XCM 23.4 ± 5.54 CTG 31.8 ± 6.86 No statistically significantly different with VAS score and OHIP-G14 questionnaire between groups. Edema on the 1st day was statistically significantly greater in XCM group, by day 3rd there was no difference Not reported Not reported Complicated healing was observed in 2 patients of the test group.…”
Objective
The gold standard for a soft tissue augmentation around implants is a subepithelial connective tissue graft (CTG), but the xenogeneic collagen matrices (XCM) started to be used as an alternative. This systematic review aimed to assess the effectiveness XCM in comparison to CTG for the increasing the thickness of the soft tissue around implants.
Data
All studies included at least two parallel groups comparing the use of CTG and XCM with a minimum follow-up of 3 months. As the primary outcome, the amount of soft tissue thickness gain after soft tissue augmentation with XCM or CTG was assessed. Secondary outcomes were clinical and patient-related outcomes; evaluation of aesthetic outcomes, patient-reported outcomes measures (PROMs) and complications. Eligible studies were selected based on the inclusion criteria. Meta-analysis was applied whenever possible. The quality of the evidence of studies including in meta-analysis was assessed using the GRADE approach.
Source
A systematic literature search up to January 2022 was conducted using the following electronic databases: PubMed (MEDLINE), Scopus, Cochrane Library, LILACS, eLIBRARY.RU. Unpublished researches, the gray literature, nonprofit reports, government studies and other materials were reviewed electronically using an EASY search. An additional manual search was carried out in November 2022.
Study selection
Of the 1376 articles from the initial search, 8 randomized controlled trials (RCTs) (306 patients and 325 implants) were included in this systematic review, and 7 studies were part of the meta-analysis. Meta-analysis revealed that XCM is less effective than the CTG in increasing soft tissue thickness around dental implants. However, XCM also provides soft tissue thickness gain and can be recommended for use in various clinical situations.
Clinical significance
Previous systematic reviews and meta-analyses have shown that autologous grafts are more effective than collagen matrices in increasing soft tissue thickness, however, the latter can be used as an alternative. Studies included in previous systematic reviews varied in design, which could lead to limitations. The present systematic review and meta-analysis includes for the first time only randomized controlled clinical trials with collagen matrix of xenogeneic origin in the test group. Tight eligibility criteria were established, and the main parameter studied was soft tissue thickness. It was found that xenogeneic collagen matrix is effective for increasing soft tissue thickness around dental implants, however, the results obtained using an autogenous connective tissue graft are superior.
“…2 . Five [ 15 , 25 , 27 , 28 , 30 ] of the included studies were considered a low risk of bias, one trial [ 26 ] was classified as a moderate risk of bias, and two studies had a high risk of bias [ 29 , 31 ]. Fig.…”
Section: Resultsmentioning
confidence: 99%
“…Meta-analysis of included studies [ 15 , 25 – 28 , 30 , 31 ] revealed that in the CTG group, the pooled mean 3-month soft tissue thickness gain in the buccal subgroup was μ = 1.0704 mm [95% CI: 0.8325 – 1.3084, I 2 = 53.1%]. Heterogeneity has been found in studies.…”
Section: Resultsmentioning
confidence: 99%
“…In order to evaluate the impact and heterogeneity of measurement methods (analog, digital) on soft tissue thickness gain in the studies, a meta-analysis was undertaken, incorporating research studies [ 15 , 25 – 28 , 30 , 31 ]. A meta-analysis revealed that within CTG group, the pooled mean 3-month soft tissue thickness gain in the analog subgroup was μ = 0.9501 mm [95% CI: 0.8668–1.0334, I 2 = 0.0%].…”
Section: Resultsmentioning
confidence: 99%
“…Soft tissues were sutured to the lingual/palatal flap with 5–0/4–0 resorbable sutures Second stage Split-thickness Derma® (Osteobiol, Tecnoss, Coazze, Torino, Italy) Thickness: 2 mm Palate Not reported Thickness: 2 mm Ashurko et.al. 2022 [ 30 ] Incision: crestal incision with a periostotomy was performed from the buccal side CTG: graft was harvested from tuber area of the upper jaw using a double incision technique XCM: the collagen matrix was modeled according to the shape of the recipient bed The XCM/SCTG was positioned with overlapping the alveolar ridge under flaps from the occlusal and buccal sides. Fixation was performed to the buccal and oral flap using mattress (horizontal) suture During implant surgery Full-thickness FibroMATRIX ® (LLC “Cardioplant”, Russia) Thickness: 1.5 mm Volume: 572.3 ± 166 mm 3 Tuber Double incision technique Thickness: 1.5 mm Hélio et al 2019 [ 31 ] Incision: standard crestal incision CTG: a mucotome with 8 mm in diameter and marking 4 mm of depth was used for graft harvesting XCM: the size of matrix was the same with CTG CTG/XCM were fixed by two simple sutures with mononylon 5.0, one to vestibular flap and the other to lingual flap.…”
Section: Methodsmentioning
confidence: 99%
“…The only significant difference in interdental papilla index was between CTG and No graft group BL—no statistically significant difference None Baseline 2.00 ± 1.2 3.87 ± 1.1 1.84 ± 1.0 1.5 months 2.80 ± 1.2 4.66 ± 0.5 2.00 ± 1.0 6 months 3.05 ± 1.3 4.91 ± 0.8 2.08 ± 1.2 Changes 1.5 months 0.08 ± 0.36 (SE) 0.5 ± 0.56 (SE) 0.08 ± 0.31 (SE) Changes 6 months 1.05 ± 0.35 (SE) 0.8 ± 0.67 (SE) 0.16 ± 0.45 (SE) Ashurko et.al. 2022 [ 30 ] No significant difference XCM 23.4 ± 5.54 CTG 31.8 ± 6.86 No statistically significantly different with VAS score and OHIP-G14 questionnaire between groups. Edema on the 1st day was statistically significantly greater in XCM group, by day 3rd there was no difference Not reported Not reported Complicated healing was observed in 2 patients of the test group.…”
Objective
The gold standard for a soft tissue augmentation around implants is a subepithelial connective tissue graft (CTG), but the xenogeneic collagen matrices (XCM) started to be used as an alternative. This systematic review aimed to assess the effectiveness XCM in comparison to CTG for the increasing the thickness of the soft tissue around implants.
Data
All studies included at least two parallel groups comparing the use of CTG and XCM with a minimum follow-up of 3 months. As the primary outcome, the amount of soft tissue thickness gain after soft tissue augmentation with XCM or CTG was assessed. Secondary outcomes were clinical and patient-related outcomes; evaluation of aesthetic outcomes, patient-reported outcomes measures (PROMs) and complications. Eligible studies were selected based on the inclusion criteria. Meta-analysis was applied whenever possible. The quality of the evidence of studies including in meta-analysis was assessed using the GRADE approach.
Source
A systematic literature search up to January 2022 was conducted using the following electronic databases: PubMed (MEDLINE), Scopus, Cochrane Library, LILACS, eLIBRARY.RU. Unpublished researches, the gray literature, nonprofit reports, government studies and other materials were reviewed electronically using an EASY search. An additional manual search was carried out in November 2022.
Study selection
Of the 1376 articles from the initial search, 8 randomized controlled trials (RCTs) (306 patients and 325 implants) were included in this systematic review, and 7 studies were part of the meta-analysis. Meta-analysis revealed that XCM is less effective than the CTG in increasing soft tissue thickness around dental implants. However, XCM also provides soft tissue thickness gain and can be recommended for use in various clinical situations.
Clinical significance
Previous systematic reviews and meta-analyses have shown that autologous grafts are more effective than collagen matrices in increasing soft tissue thickness, however, the latter can be used as an alternative. Studies included in previous systematic reviews varied in design, which could lead to limitations. The present systematic review and meta-analysis includes for the first time only randomized controlled clinical trials with collagen matrix of xenogeneic origin in the test group. Tight eligibility criteria were established, and the main parameter studied was soft tissue thickness. It was found that xenogeneic collagen matrix is effective for increasing soft tissue thickness around dental implants, however, the results obtained using an autogenous connective tissue graft are superior.
Objectives: Limited information is available about the biological characterization of peri-implant soft tissue at the transcriptional level. The aim of this study was to investigate the effect of dental implant on the gingival tissue in vivo by using paired samples and compare the differences between peri-implant and periodontal gingiva at the transcriptional level.Methods: Paired peri-implant soft tissue and periodontal gingiva tissue from 6 patients were obtained, and the pooled RNAs were analyzed by deep sequencing. Venn diagram was used to further screen out differentially expressed genes in every pair of samples. Annotation and enrichment analysis was performed. Further veri cation was done by quantitative real-time PCR.Results: A total of 3549 genes including were found differently expressed between peri-implant and periodontal groups. The Venn diagram further identi ed 185 genes differentially expressed genes (DEGs) in every pair of samples, of which the enrichment analysis identi ed signi cant enrichment for cellular component was associated with external side of plasma membrane, for molecular function was protein binding, for biological process was immune system process, and for KEGG pathway was cytokinecytokine receptor interaction. Among the DEGs, CST1, SPP1, AQP9 and SFRP2 were veri ed to be upregulated in peri-implant soft tissue.Conclusions: Peri-implant gingiva showed altered expressions of several genes related to the cell-ECM interaction.Clinical Relevance: At the transcriptional level, healthy periodontal is alternative to the healthy periimplant soft tissue as the control of peri-implantitis to a large extent, except in the research related to cell-ECM interactions.
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