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Volume 13
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Systematic Review

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

by
Martina Stefanini
1,
Alberto Pispero
2,
Massimo Del Fabbro
2,3,
Luca Gobbato
4,
Paolo Ghensi
5,*,
Giovanni Lodi
2,
Anton Sculean
6,
Giovanni Zucchelli
1 and
Maria Gabriella Grusovin
7
1
Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy
2
Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
3
Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milano, Italy
4
Department of Neurosciences, University of Padova, 35122 Padova, Italy
5
Department CIBIO, University of Trento, 38122 Trento, Italy
6
Department of Periodontology, University of Bern, 3012 Bern, Switzerland
7
Independent Researcher, 34170 Gorizia, Italy
*
Author to whom correspondence should be addressed.
†
The manuscript represents the Proceedings of a Consensus Conference of the Italian Academy of Osseointegration (IAO, https://www.iao-online.com, accessed on 8 June 2023).
Appl. Sci. 2023, 13(15), 8631; https://doi.org/10.3390/app13158631
Submission received: 9 June 2023 / Revised: 18 July 2023 / Accepted: 19 July 2023 / Published: 26 July 2023
(This article belongs to the Section Applied Dentistry and Oral Sciences)
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Abstract

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.
Keywords: keratinized mucosa; PROMs; peri-implant health; implant failure; systematic review; meta-analysis keratinized mucosa; PROMs; peri-implant health; implant failure; systematic review; meta-analysis

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MDPI and ACS Style

Stefanini, M.; Pispero, A.; Del Fabbro, M.; Gobbato, L.; Ghensi, P.; Lodi, G.; Sculean, A.; Zucchelli, G.; Grusovin, M.G. The Effect of Keratinized Mucosa on Peri-Implant Health and Patient-Reported Outcome Measures: A Systematic Review and Meta-Analysis. Appl. Sci. 2023, 13, 8631. https://doi.org/10.3390/app13158631

AMA Style

Stefanini M, Pispero A, Del Fabbro M, Gobbato L, Ghensi P, Lodi G, Sculean A, Zucchelli G, Grusovin MG. The Effect of Keratinized Mucosa on Peri-Implant Health and Patient-Reported Outcome Measures: A Systematic Review and Meta-Analysis. Applied Sciences. 2023; 13(15):8631. https://doi.org/10.3390/app13158631

Chicago/Turabian Style

Stefanini, Martina, Alberto Pispero, Massimo Del Fabbro, Luca Gobbato, Paolo Ghensi, Giovanni Lodi, Anton Sculean, Giovanni Zucchelli, and Maria Gabriella Grusovin. 2023. "The Effect of Keratinized Mucosa on Peri-Implant Health and Patient-Reported Outcome Measures: A Systematic Review and Meta-Analysis" Applied Sciences 13, no. 15: 8631. https://doi.org/10.3390/app13158631

APA Style

Stefanini, M., Pispero, A., Del Fabbro, M., Gobbato, L., Ghensi, P., Lodi, G., Sculean, A., Zucchelli, G., & Grusovin, M. G. (2023). The Effect of Keratinized Mucosa on Peri-Implant Health and Patient-Reported Outcome Measures: A Systematic Review and Meta-Analysis. Applied Sciences, 13(15), 8631. https://doi.org/10.3390/app13158631

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