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Meta-Analysis
. 2022 Jun;24(3):287-300.
doi: 10.1111/cid.13080. Epub 2022 Mar 17.

The role of keratinized mucosa width as a risk factor for peri-implant disease: A systematic review, meta-analysis, and trial sequential analysis

Andrea Ravidà  1 , Claudia Arena  2 , Mustafa Tattan  3   4 , Vito Carlo Alberto Caponio  2 , Muhammad H A Saleh  5 , Hom-Lay Wang  1 , Giuseppe Troiano  2
Affiliations
Meta-Analysis

The role of keratinized mucosa width as a risk factor for peri-implant disease: A systematic review, meta-analysis, and trial sequential analysis

Andrea Ravidà et al. Clin Implant Dent Relat Res. 2022 Jun.

Abstract

Background: Studies have examined the benefit of having keratinized peri-implant mucosa width with mixed results.

Purpose: This study examines whether the lack of a prespecified (2 mm) amount of keratinized mucosa width (KMW) is a risk factor for peri-implant diseases.

Methods: A systematic electronic and manual search of randomized or nonrandomized controlled or noncontrolled clinical trials was conducted. Qualitative review, quantitative meta-analysis, and trial sequence analysis (TSA) of implants inserted at sites with <2 mm or ≥2 mm of KMW were analyzed to compare all the predetermined outcome variables. The level of evidence concerning the role of KMW in peri-implant health was evaluated via the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system guide.

Results: Nine studies were included in the qualitative analysis and four in the meta-analysis and TSA. No significant inter-group difference (p > 0.05) and a low power of evidence were found for probing depth, soft-tissue recession, and marginal bone loss. A significant difference favoring ≥2 mm KMW had a lower mean plaque index (MD = 0.37, 95% CI: [0.16, 0.58], p = 0.002) (3 studies, 430 implants, low-quality evidence). GRADE system showed very low and low quality of evidence for all other outcome measures.

Conclusion: Based on the available studies, the impact of amount of KMW (either <2 mm or ≥ 2 mm) as a risk factor for developing peri-implant disease remains low. Future control studies with proper sample size and longer follow-up are needed to further validate current findings.

Keywords: alveolar bone loss; dental implants; gingival recession; meta-analysis; oral mucosa.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

FIGURE 1
FIGURE 1
PRISMA flowchart of the selection process
FIGURE 2
FIGURE 2
Meta‐analysis (A) and trial sequential analysis (B) of marginal bone loss; meta‐analysis (C) and trial Sequential Analysis (D) of probing depth change
FIGURE 3
FIGURE 3
Meta‐analysis (A) and trial sequential analysis (B) of soft‐tissue recession; meta‐analysis (C) and trial sequential analysis (D) of mean plaque index
See this image and copyright information in PMC

References

    1. Avila‐Ortiz G, Gonzalez‐Martin O, Couso‐Queiruga E, Wang HL. The peri‐implant phenotype. J Periodontol. 2020;91(3):283‐288. - PubMed
    1. Parpaiola A, Cecchinato D, Toia M, Bressan E, Speroni S, Lindhe J. Dimensions of the healthy gingiva and peri‐implant mucosa. Clin Oral Implants Res. 2015;26(6):657‐662. - PubMed
    1. Adell R, Eriksson B, Lekholm U, Branemark PI, Jemt T. Long‐term follow‐up study of osseointegrated implants in the treatment of totally edentulous jaws. Int J Oral Maxillofac Implants. 1990;5(4):347‐359. - PubMed
    1. Schrott AR, Jimenez M, Hwang JW, Fiorellini J, Weber HP. Five‐year evaluation of the influence of keratinized mucosa on peri‐implant soft‐tissue health and stability around implants supporting full‐arch mandibular fixed prostheses. Clin Oral Implants Res. 2009;20(10):1170‐1177. - PMC - PubMed
    1. Zigdon H, Machtei EE. The dimensions of keratinized mucosa around implants affect clinical and immunological parameters. Clin Oral Implants Res. 2008;19(4):387‐392. - PubMed

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