Effect of peri‐implant mucosal thickness on esthetic outcomes and the efficacy of soft tissue augmentation procedures: Consensus report of group 2 of the SEPA/DGI/OF workshop

• Published in: Clinical oral implants research 2022-06, Vol.33 (S23), p.100-108
• Main Authors: Jung, Ronald E., Becker, Kathrin, Bienz, Stefan P., Dahlin, Christer, Donos, Nikos, Hammächer, Christian, Iglhaut, Gerhard, Liñares, Antonio, Ortiz‐Vigón, Alberto, Sanchez, Nerea, Sanz‐Sánchez, Ignacio, Thoma, Daniel S., Valles, Cristina, Weng, Dietmar, Nart, José
• Format: Article
• Language: English
• Subjects: abutment material; anterior single implants; Augmentation; Clinical trials; collagen; color; color measurement; Connective tissue; Connective tissues; Dental implants; Dentistry; Engineering; esthetic outcomes; gingival biotype; Grafting; grafts; implant dentistry; Literature reviews; management; Materials substitution; matrix; Mucosa; Odontologi; Oral Surgery & Medicine; papilla index; patient-reported outcome measures; peri-implant; peri-implant mucosa; peri‐implant soft tissue; pink esthetic score; Prostheses; Questions; restorations; Skin & tissue grafts; soft tissue; Soft tissues; stability; Thickness; thin; Tissues
• ISSN: 0905-7161; 1600-0501
• DOI: 10.1111/clr.13955

Objectives The aim of this study was to comprehensively assess the literature in terms of the effect of peri‐implant mucosal thickness on esthetic outcomes and the efficacy of soft tissue augmentation procedures to increase the mucosal thickness with autogenous grafts or soft tissue substitutes. Material and methods Two systematic reviews (SR) were performed prior to the consensus meeting to assess the following questions. Review 1, focused question: In systemically healthy patients with an implant‐supported fixed prosthesis, what is the influence of thin as compared to thick peri‐implant mucosa on esthetic outcomes? Review 2, focused question 1: In systemically healthy humans with at least one dental implant (immediate or staged implant), what is the efficacy of connective tissue graft (CTG), as compared to absence of a soft tissue grafting procedure, in terms of gain in peri‐implant soft tissue thickness (STT) reported by randomized controlled clinical trials (RCTs) or controlled clinical trials (CCTs)? Review 2, focused question 2: In systemically healthy humans with at least one dental implant (immediate or staged implant), what is the efficacy of CTG, as compared to soft tissue substitutes, in terms of gain in peri‐implant STT reported by RCTs or CCTs? The outcomes of the two SRs, the consensus statements, the clinical implications, and the research recommendations were discussed and subsequently approved at the consensus meeting during the group and plenary sessions. Conclusions There was a tendency of superior esthetic outcomes in the presence of a thick mucosa. The connective tissue graft remains the standard of care in terms of increasing mucosa thickness.