Peri-implant Soft Tissue Stability After Single Implant Restorations Using Either Guided Bone Regeneration or a Connective Tissue Graft: A Randomized Clinical Trial

Abstract

The purpose of the present study was to compare two different surgical procedures, connective tissue graft and guided bone regeneration, when applied in conjunction with implant placement. Probing pocket depth and the recession depth were recorded at the implant site after crown placement (T₁) and at the 1-year follow-up (T₂), while the keratinized tissue height and the buccal mucosa thickness were recorded at three different time points: at the time of implant surgery (T₀), after crown placement, and at the 1-year follow-up. No statistically significant differences in peri-implant mucosa thickness, recession, or other periodontal parameters were recorded at adjacent teeth.

Impact of timing on soft tissue augmentation during implant treatment: A systematic review and meta‐analysis

“…The risk of bias in eight included RCTs were assessed and summarized (Table ), two studies (Bianchi & Sanfilippo, ; Sanz et al., ) (25%) of unclear risk of bias for allocation concealment, one study (Bianchi & Sanfilippo, ) (12.5%) of high risk, and two studies (Sanz et al., ; Zuiderveld et al., ) (25%) of unclear risk of bias for participants and personnel, and one study (D'Elia et al., ) (12.5%) with selective reporting due to no baseline data. Also, most of the included articles (7 of 14, 87.5%) revealed an unclear risk of bias for blinding of the outcome assessment (Bianchi & Sanfilippo, ; Cairo et al., ; D'Elia et al., ; Lorenzo et al., ; Sanz et al., ; Zeltner et al., ; Zuiderveld et al., ). Only one controlled clinical trial had seven stars and showed the “medium–high” level of evidence (Wiesner et al., ) (Table ).…”

“…Different methods/tools were used for soft tissue assessment, which include but are not limited to sounding with stopper, ultrasonic device, cast‐superimposed technique, and three dimension image based on intraoral photos (Zeltner et al., ). To minimize the possible bias, the meta‐analysis of STT merely included the data from sounding (D'Elia et al., ; Wiesner et al., ; Zucchelli et al., ) and ultrasonic measurement (De Bruyckere et al., ). To be more specific, the details in STT change for ultrasonic device could be up to 0.01 mm, which is more accurate than the conventional tools (endodontic ruler, caliper, or periodontal probe).…”

“…Even though full mouth tooth sites were able to be chosen (Bianchi & Sanfilippo, 2004), the majority of implant sites were located at upper dentition, including esthetic priority areas (maxillary premolar to premolar). On the other hand, only two studies (D'Elia et al, 2017;Wiesner, Esposito, Worthington, & Schlee, 2010) were associated with nonimmediate implant and soft tissue graft at the same time in SNI group. Unlike tunnel technique for minimal-invasive considerations, one study placed soft tissue graft with concomitant GBR procedure, and access flap was performed (D'Elia et al, 2017).…”

“…On the other hand, only two studies (D'Elia et al, 2017;Wiesner, Esposito, Worthington, & Schlee, 2010) were associated with nonimmediate implant and soft tissue graft at the same time in SNI group. Unlike tunnel technique for minimal-invasive considerations, one study placed soft tissue graft with concomitant GBR procedure, and access flap was performed (D'Elia et al, 2017). In StI and StN groups, soft tissue augmentation can be performed from 1.5 to 6 months after implant placement or at the uncovered stage, and there was only one article included from the StI group (Cosyn, Bruyn, & Cleymaet, 2013).…”

The effectiveness of immediate implant placement for single tooth replacement compared to delayed implant placement: A systematic review and meta‐analysis

“…RCTs demonstrated significantly less midfacial recession following the application of a connective tissue graft in the buccal mucosa following IIP (Frizzera et al., ; Yoshino, Kan, Rungcharassaeng, Roe, & Lozada, ; Zuiderveld, Meijer, den Hartog, Vissink, & Raghoebar, ). Connective tissue grafts also appear beneficial to restore buccal convexity following DIP (D'Elia et al., ; De Bruyckere, Eghbali, Younes, De Bruyn, & Cosyn, ; De Bruyckere et al., ; Eghbali, De Bruyn, Cosyn, Kerckaert, & Hoof, ; Eghbali et al., ; Hanser & Khoury, ; Stefanini et al., ). Clearly, state‐of‐the‐art implant therapy often requires soft tissue grafting following IIP as well as following DIP.…”