The Effect of Keratinized Mucosa on Peri-Implant Health and Patient-Reported Outcome Measures: A Systematic Review and Meta-Analysis

Autor: Martina Stefanini, Alberto Pispero, Massimo Del Fabbro, Luca Gobbato, Paolo Ghensi, Giovanni Lodi, Anton Sculean, Giovanni Zucchelli, Maria Gabriella Grusovin
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Applied Sciences, Vol 13, Iss 15, p 8631 (2023)
Druh dokumentu: article
ISSN: 2076-3417
65487427
DOI: 10.3390/app13158631
Popis: Objectives: The aim of this systematic review was to analyze the effect of keratinized mucosa (KM) on different peri-implant health-related parameters and on patient-reported outcome measures (PROMs). Material and methods: Randomized controlled trials, cohort, cross-sectional and case–control human studies with a follow-up period of at least 6 months comparing two groups of patients with presence or absence of KM, or with KM < 2 mm or ≥2 mm were included. Primary outcomes were implant failures, PROMs and BoP (BoP/mBI). Additional outcomes were PPD, plaque accumulation (mPI/PI), gingival inflammation (GI/mGI), marginal bone loss (MBL), soft tissue recession (REC) and biological complications. Results: Fifteen studies were included (one RCT, two cohort prospective and twelve cross-sectional). Meta-analysis was performed for cross-sectional studies. Implant failure and complications were not presented as outcome measures, and five studies analyzed PROMs. Results from the meta-analysis reported no evidence of any statistical significant difference between groups in PPD, BoP and MBL, while a statistical significant difference in GI/BI, PI and REC was present in favor of the group with KW ≥ 2 mm. More biological complications were present in the group with no KM/KM < 2 mm but few cases were present to draw any conclusions. Although a meta-analysis could not be performed, a consistent trend toward the worst pain/discomfort in KM < 2 mm was observed. Conclusions: No clear evidence was found supporting the role of KM in peri-implant health and PROMs, even if more plaque and marginal inflammation were present in the KM < 2 mm group. Clinical relevance: KM could have a role in patients with erratic maintenance and patient comfort.
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