The significance of surgically modifying soft tissue phenotype around fixed dental prostheses: An American Academy of Periodontology best evidence review.

Abstract

This systematic review endeavored to investigate the effect of soft tissue phenotype modification therapy (PhMT-s) at sites with a tooth or an implant supported fixed dental prosthesis. A comprehensive literature search was conducted by two independent examiners to identify relevant studies reporting differences in clinical, esthetic, or radiographic outcomes of interest between sites underwent PhMT-s and sites that remained untreated. Risk of bias assessment was calculated for all included studies. Meta-analyses involving endpoints of interest were performed when feasible. No controlled studies pertaining to tooth sites were identified. A total of six articles reporting on the outcomes of buccal soft tissue phenotype modification around implants were selected, of which, five were included in the meta-analyses. Quantitative analyses showed a weighted mean difference (WMD) of 0.98mm (95% CI = 0.25 to 1.72mm, P = 0.009) for change of tissue thickness; a WMD of -4.87% (95% CI = -34.27 to 24.53%, P = 0.75) for bleeding on probing (BOP); a WMD of 0.36mm (95% CI = 0.12 to 0.59mm, P = 0.003) for mucosal recession (MR); a WMD of 0.13mm (95% CI = -0.11 to 0.36mm, P = 0.30 for probing depth (PD); a WMD of 1.08 (95% CI = -0.39 to 2.55, P = 0.15) for pink esthetic score (PES), and a WMD of 0.40mm (95% CI = -0.34 to 1.14mm, P = 0.28) for marginal bone loss (MBL). Surgical modification of peri-implant soft tissue phenotype via PhMT-s may decrease the amount of MR. Future clinical trials are needed to warrant the clinical benefits of modifying soft tissue phenotype around tooth-supported restorations.