Soft tissue management at implants: Summary and consensus statements of group 2. The 6th EAO Consensus Conference 2021

Daniel S Thoma; Jan Cosyn; Stefan Fickl; Simon S Jensen; Ronald E Jung; Gerry M Raghoebar; Isabella Rocchietta; Mario Roccuzzo; Mariano Sanz; Ignacio Sanz-Sánchez; Pavel Scarlat; Soren Schou; Martina Stefanini; Malin Strasding; Kristina Bertl; working group 2 of the 6th EAO Consensus Conference 2021

doi:10.1111/clr.13798

Soft tissue management at implants: Summary and consensus statements of group 2. The 6th EAO Consensus Conference 2021

Clin Oral Implants Res. 2021 Oct;32 Suppl 21(Suppl 21):174-180. doi: 10.1111/clr.13798.

Authors

Daniel S Thoma¹, Jan Cosyn^{2

3}, Stefan Fickl^{4

5}, Simon S Jensen^{6

7}, Ronald E Jung¹, Gerry M Raghoebar⁸, Isabella Rocchietta⁹, Mario Roccuzzo^{10

11}, Mariano Sanz¹², Ignacio Sanz-Sánchez¹³, Pavel Scarlat¹⁴, Soren Schou¹⁵, Martina Stefanini¹⁶, Malin Strasding¹⁷, Kristina Bertl^{18

19}; working group 2 of the 6th EAO Consensus Conference 2021

Affiliations

¹ Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland.
² Department of Periodontology and Oral Implantology, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
³ Faculty of Medicine and Pharmacy, Oral Health Research Group (ORHE), Vrije Universiteit Brussel (VUB), Brussels, Belgium.
⁴ Private Practice, Fürth, Germany.
⁵ Division of Periodontology, University of Würzburg, Würzburg, Germany.
⁶ Department of Oral and Maxillofacial Surgery, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark.
⁷ Department of Oral and Maxillofacial Surgery, School of Dentistry, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
⁸ Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
⁹ Department of Periodontology, UCL Eastman Dental Institute, University College London, London, England.
¹⁰ Private Practice, Torino, Italy.
¹¹ Division of Maxillofacial Surgery, University of Torino, Torino, Italy.
¹² Department of Dental Clinical Specialities, School of Dentistry, Complutense University of Madrid, Madrid, Spain.
¹³ ETEP (Etiology and Therapy of Periodontal and Peri-Implant Diseases) Research Group, University Complutense of Madrid, Madrid, Spain.
¹⁴ Private Practice, Canton Valais/Vaud, Switzerland.
¹⁵ Department of Periodontology, School of Dentistry, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
¹⁶ Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.
¹⁷ Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland.
¹⁸ Department of Periodontology, Faculty of Odontology, University of Malmö, Malmö, Sweden.
¹⁹ Division of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria.

Abstract

Objectives: The task of working Group 2 at the 6th Consensus Meeting of the European Association for Osseointegration was to comprehensively assess the effects of soft tissue augmentation procedures at dental implant sites on clinical, radiographic and patient-reported outcome measures (PROMs) including an overview on available outcome measures and methods of assessment.

Materials and methods: Three systematic reviews and one critical review were performed in advance on (i) the effects of soft tissue augmentation procedures on clinical, radiographic and aesthetic outcomes, (ii) reliability and validity of outcome measures and methods of assessment and (iii) PROMs applied in clinical studies for soft tissue augmentation procedures at dental implant sites. Major findings, consensus statements, clinical recommendations and implications for future research were discussed in the group and approved during the plenary sessions.

Results: The four reviews predominantly revealed: Soft tissue augmentation procedures in conjunction with immediate and delayed implant placement result in superior aesthetic outcomes compared to no soft tissue augmentation in the zone of aesthetic priority. Soft tissue augmentation procedures have a limited effect on marginal bone level changes compared to implant sites without soft tissue augmentation. Clinically relevant parameters (gingival index, mucosal recession) and plaque control improve at implant sites when the width of keratinised mucosa is increased. A variety of aesthetic indices have been described with good reliability. Pink Esthetic Score and Complex Esthetic Index are the most validated aesthetic indices for single implants, though. Superimposed digital surface scans are most accurate to assess profilometric tissue changes. PROMs following soft tissue augmentation procedures have been assessed using various forms of questionnaires. Soft tissue augmentation had a limited effect on PROMs.

Conclusions: Soft tissue augmentation procedures are widely applied in conjunction with implant therapy. Depending on the indication of these interventions, clinical, radiographic and aesthetic outcomes may improve, whereas the effect on PROMs is limited.

Keywords: dental implant; patient-reported outcome measures; soft tissue augmentation.

Publication types

Review

MeSH terms

Dental Implants*
Esthetics, Dental
Humans
Reproducibility of Results

Substances

Dental Implants

Grants and funding

European Association for Osseointegration (EAO)