Linear and profilometric changes of the mucosa following soft tissue augmentation in the zone of aesthetic priority: A systematic review and meta‐analysis

Abstract Objectives To assess the outcomes of soft tissue augmentation, in terms of change in level and thickness of mid‐buccal mucosa, at implants sites in the zone of the aesthetic priority. Material and Methods MEDLINE, EMBASE and Cochrane Central Register of Controlled Trials databases were searched (last search on 1 June 2020). Inclusion criteria were studies reporting outcomes of different materials and timing of grafting in patients undergoing soft tissue augmentation at implant sites in the aesthetic zone with a follow‐up of ≥1 year after implant placement. Outcome measures assessed included changes in level and thickness of mid‐buccal mucosa, implant survival, peri‐implant health and patients’ satisfaction. Results Eighteen out of 2,185 articles fulfilled the inclusion criteria. Meta‐analysis revealed a significant difference in vertical mid‐buccal soft tissue change (0.34 mm, 95% CI: 0.13–0.56, p = .002) and mid‐buccal mucosa thickness (0.66 mm, 95% CI: 0.35–0.97, p < .001) following immediate implant placement in favour of the use of a graft versus no graft. Mean difference in mid‐buccal mucosa level following delayed implant placement (0.17 mm, 95% CI: 0.01–0.34, p = .042) was also in favour of the use of a graft versus no graft. With regard to mucosa thickness, the use of a graft was not in favour compared with no graft following delayed implant placement (0.22 mm, 95% CI: −0.04–0.47, p = .095). Observed changes remained stable in the medium term. Conclusion Soft tissue augmentation in the zone of the aesthetic priority results in less recession and a thicker mid‐buccal mucosa following immediate implant placement and less recession in mid‐buccal mucosa following delayed implant placement compared with no graft.