Int J Stomatol

Inter J Stomatol ›› 2019, Vol. 46 ›› Issue (2): 149-155.doi: 10.7518/gjkq.2019018

• Systematic Reviews • Previous Articles     Next Articles

Effect of keratinized mucosa width on peri-implant bone loss

Jie Huang,Yunhong Lin()   

  1. Dept. of Prosthodontics, Affiliated Hospital of Stomatology, Kunming Medical University, Kunming 650000, China
  • Received:2018-05-27 Revised:2018-11-06 Online:2019-03-01 Published:2019-03-15
  • Contact: Yunhong Lin E-mail:linyunhon@163.com

RichHTML

11

PDF (PC)

232

Abstract:

Objective The existence of keratinized gingival tissue around the mouth of the oral implant is considered as a mucosal barrier around the implant. The existence of keratinized gingival tissue ensures long-term stability of the tissue around the implants. In this study, Meta-analysis was performed to summarize the clinical controlled trials of dental implants in patients with dental implants. Methods An electronic search strategy was performed on EMBASE (Ovid), Cochrane (CENTRAL), Medline, Pubmed, China Biology Medicine disc, China National Knowledge Infrastructure, National Library of Medicine, and Campbell Library. Then, the extraction of the included studies and risk of bias assessment with the recommended tool of Cochrane collaboration was performed until May 2017. Meta-analysis was processed by Rveman 5.3. Three evaluators independently used the Cochrane quality evaluation form to evaluate the methodological quality of the included studies. According to the inclusion and exclusion criteria, we screened related studies, extracted data, and evaluated risk bias. Results At the end of screening, 10 studies with moderate bias risk were included, 8 of which were retrospective studies, and 2 were prospective studies. The main focus of the study was the correlation between the width of the keratinized gingival tissue around the oral implant and the loss of bone around the implant. The outcome indicators included bone loss, height of bone loss, marginal bone loss, and follow-up time are more than 2 months. The Meta-analysis results showed that evident heterogeneity was excluded, the results were stable, and the quality of evidence was high. The results also showed the width of the keratinized gingival tissue around the implant and bone absorption without negative correlation (P<0.01). With the increase in the width of the keratinized gingival tissue and decrease in bone resorption, the keratinized gingival tissue exhibited a protective effect on the peri-implant bone tissue. However, many influencing factors, including bone height around the body and the strength of the immunity, diet, and compliance, need further high-quality control testing to confirm the results. Conclusion No negative correlation was observed between the width of keratinized gingival tissue and the degree of bone loss around the implant. Therefore, in future clinical work, we should preserve the keratinized gingival tissue to increase the bone stability around the implant.

Key words: keratinized mucosa width, peri-implant bone height, Meta-analysis

CLC Number: 

  • R783.4

TrendMD: 

Fig 1

Document screening process and results"

Fig 2

Judgements about each risk of bias item for each included study"

Tab 1

Characteristics of included studies"

参考文献 日期 国家 类型 纳入患者数 植体数目 平均随访时间
[12] 1987 美国 前瞻性 26 58 ≥2年
[15] 2014 巴西 回顾性 32 161 ≥1年
[16] 2009 韩国 回顾性 100 276 1年1个月
[17] 2015 芬兰 回顾性 211 967 1年3个月
[18] 2015 土耳其 回顾性 18 60 3个月、6个月
[19] 2015 巴西 回顾性 193 725 ≥5年
美国 <5年
[20] 2016 意大利 回顾性 103 421 >2年
[21] 2006 美国 前瞻性 69 339 8.1年
[22] 2009 伊朗 回顾性 未提及 66 1年6个月
[23] 2008 美国 回顾性 未提及 200 4.91年

Fig 3

Analysis table when no heterogeneous source is removed"

Fig 4

Analysis table after removal of heterogeneous sources"

Fig 5

Subgroup analysis"

[1] Albrektsson T, Zarb G, Worthington P , et al. The Long-term efficacy of currently used dental implants: a review and proposed criteria of success[J]. Int J Oral Maxillofac Implants, 1986,1(1):11-25.
[2] Albrektsson T, Buser D, Sennerby L . On crestal/mar-ginal bone loss around dental implants[J]. Int J Oral Maxillofac Implants, 2012,27(4):736-738.
doi: 10.1038/sj.bdj.2012.611 pmid: 23342341
[3] Misch CE, Perel ML, Wang HL , et al. Implant success, survival, and failure: the international congress of oral implantologists (ICOI) pisa consensus conference[J]. Implant Dent, 2008,17(1):5-15.
doi: 10.1097/ID.0b013e3181676059 pmid: 18332753
[4] Papaspyridakos P, Chen CJ, Singh M , et al. Success criteria in implant dentistry: a systematic review[J]. J Dent Res, 2012,91(3):242-248.
doi: 10.1177/0022034511431252
[5] Annibali S, Bignozzi I, La Monaca G , et al. Usefulness of the aesthetic result as a success criterion for im-plant therapy: a review[J]. Clin Implant Dent Relat Res, 2012,14(1):3-40.
doi: 10.1111/j.1708-8208.2009.00234.x pmid: 19673953
[6] Fürhauser R, Florescu D, Benesch T , et al. Evaluation of soft tissue around single-tooth implant crowns: the pink esthetic score[J]. Clin Oral Implants Res, 2005,16(6):639-644.
doi: 10.1111/j.1600-0501.2005.01193.x pmid: 16307569
[7] Sohrabi K, Mushantat A, Esfandiari S , et al. How successful are small-diameter implants? A literature review[J]. Clin Oral Implants Res, 2012,23(5):515-525.
doi: 10.1111/j.1600-0501.2011.02410.x pmid: 22313216
[8] Severino VO, Napimoga MH, de Lima Pereira SA . Expression of IL-6, IL-10, IL-17 and IL-8 in the peri-implant crevicular fluid of patients with peri-implan-titis[J]. Arch Oral Biol, 2011,56(8):823-828.
doi: 10.1016/j.archoralbio.2011.01.006 pmid: 21306703
[9] Luo L, Xie P, Gong P , et al. Expression of HMGB1 and HMGN2 in gingival tissues, GCF and PICF of periodontitis patients and peri-implantitis[J]. Arch Oral Biol, 2011,56(10):1106-1111.
doi: 10.1590/S1517-838220110003000047 pmid: 3768754
[10] Loe H, Theilade E, Jensen SB . Experimental gingivitis in Man[J]. J Periodontol, 1965,36:177-187.
doi: 10.1902/jop.1965.36.3.177
[11] Lang NP, Löe H . The relationship between the width of keratinized gingiva and gingival health[J]. J Perio-dontol, 1972,43(10):623-627.
doi: 10.1902/jop.1972.43.10.623 pmid: 4507712
[12] Stetler KJ, Bissada NF . Significance of the width of keratinized gingiva on the periodontal status of teeth with submarginal restorations[J]. J Periodontol, 1987,58(10):696-700.
doi: 10.1902/jop.1987.58.10.696 pmid: 2444693
[13] Greenstein G, Cavallaro J . The clinical significance of keratinized gingiva around dental implants[J]. Compend Contin Educ Dent, 2011,32(8):24-32, 34.
doi: 10.1111/j.1444-0938.1976.tb01428.x pmid: 22073807
[14] Mehta P, Lim LP . The width of the attached gingiva: much ado about nothing[J]. J Dent, 2010,38(7):517-525.
doi: 10.1016/j.jdent.2010.04.007 pmid: 20403409
[15] Passoni BB, Dalago HR, Schuldt Filho G , et al. Does the number of implants have any relation with peri-implant disease[J]. J Appl Oral Sci, 2014,22(5):403-408.
doi: 10.1590/1678-775720140055 pmid: 4245752
[16] Kim BS, Kim YK, Yun PY , et al. Evaluation of peri-implant tissue response according to the presence of keratinized mucosa[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2009,107(3):e24-e28.
doi: 10.1016/j.tripleo.2008.12.010 pmid: 19217009
[17] Ladwein C, Schmelzeisen R, Nelson K , et al. Is the presence of keratinized mucosa associated with periimplant tissue health? A clinical cross-sectional analysis[J]. Int J Implant Dent, 2015,1(1):11.
doi: 10.1186/s40729-015-0009-z pmid: 5005560
[18] Buyukozdemir Askin S, Berker E, Akincibay H , et al. Necessity of keratinized tissues for dental implants: a clinical, immunological, and radiographic study[J]. Clin Implant Dent Relat Res, 2015,17(1):1-12.
doi: 10.1111/cid.12079 pmid: 23631746
[19] Ferreira CF, Buttendorf AR, de Souza JG, et al. Pre-valence of peri-implant diseases: analyses of associated factors[J]. Eur J Prosthodont Restor Dent, 2015,23(4):199-206.
doi: 10.1992/EJPRD_ pmid: 26767242
[20] Poli PP, Beretta M, Grossi GB , et al. Risk indicators related to peri-implant disease: an observational re-trospective cohort study[J]. J Periodont Implant Sci, 2016,46(4):266-276.
doi: 10.5051/jpis.2016.46.4.266 pmid: 27588216
[21] Chung DM, Oh TJ, Shotwell JL , et al. Significance of keratinized mucosa in maintenance of dental im-plants with different surfaces[J]. J Periodontol, 2006,77(8):1410-1420.
doi: 10.1902/jop.2006.050393 pmid: 16881810
[22] Adibrad M, Shahabuei M, Sahabi M . Significance of the width of keratinized mucosa on the health status of the supporting tissue around implants supporting overdentures[J]. J Oral Implantol, 2009,35(5):232-237.
doi: 10.1563/AAID-JOI-D-09-00035.1 pmid: 19882819
[23] Bouri A Jr, Bissada N, Al-Zahrani MS , et al. Width of keratinized gingiva and the health status of the supporting tissues around dental implants[J]. Int J Oral Maxillofac Implants, 2008,23(2):323-326.
doi: 10.1016/j.ijom.2007.09.170 pmid: 18548930
[24] Leonhardt A, Renvert S, Dahlén G . Microbial findings at failing implants[J]. Clin Oral Implants Res, 1999,10(5):339-345.
doi: 10.1034/j.1600-0501.1999.100501.x pmid: 10551058
[25] Quirynen M, Vogels R, Peeters W , et al. Dynamics of initial subgingival colonization of ‘pristine’ peri-implant pockets[J]. Clin Oral Implants Res, 2006,17(1):25-37.
doi: 10.1111/j.1600-0501.2005.01194.x pmid: 16441782
[26] Augthun M, Conrads G . Microbial findings of deep peri-implant bone defects[J]. Int J Oral Maxillofac Implants, 1997,12(1):106-112.
pmid: 9048462
[27] Salcetti JM, Moriarty JD, Cooper LF , et al. The clinical, microbial, and host response characteristics of the failing implant[J]. Int J Oral Maxillofac Implants, 1997,12(1):32-42.
doi: 10.1111/j.1365-2591.1997.tb01101.x pmid: 9048452
[28] Abrahamsson I, Berglundh T, Wennström J , et al. The peri-implant hard and soft tissues at different implant systems. A comparative study in the dog[J]. Clin Oral Implants Res, 1996,7(3):212-219.
doi: 10.1034/j.1600-0501.1996.070303.x pmid: 9151585
[29] Berglundh T, Lindhe J, Marinello C , et al. Soft tissue reaction to de novo plaque formation on implants and teeth. An experimental study in the dog[J]. Clin Oral Implants Res, 1992,3(1):1-8.
doi: 10.1034/j.1600-0501.1992.030101.x
[30] Ericsson I, Berglundh T, Marinello C , et al. Long-standing plaque and gingivitis at implants and teeth in the dog[J]. Clin Oral Implants Res, 1992,3(3):99-103.
doi: 10.1034/j.1600-0501.1992.030301.x pmid: 1290796
[31] Toijanic JA, Ward CB, Gewerth ME , et al. A longitu-dinal clinical comparison of plaque-induced inflam-mation between gingival and peri-implant soft tissues in the maxilla[J]. J Periodontol, 2001,72(9):1139-1145.
doi: 10.1902/jop.2000.72.9.1139 pmid: 11577943
[1] Gong Jiaming,Zhao Ruimin,Pan Hongwei,Lang Xin,Yu Zhanhai,Li Jianxue. Meta-analysis of dynamic navigation versus static navigation in the accuracy of implant surgery [J]. Int J Stomatol, 2023, 50(5): 538-551.
[2] revascularization Meta-analysis of the efficacy comparison between endodontic,Zhuanzhuan apexification Li. OSID） [J]. Int J Stomatol, 2023, 50(2): 177-185.
[3] Gong Jiaming,Zhao Ruimin,Li Wanxin,Su Linhan,Yu Zhanhai,Li Jianxue. The socket-shield technique for immediate implant placement： a meta-analysis of randomized controlled trials [J]. Int J Stomatol, 2022, 49(5): 537-547.
[4] Zhang Shan,Ge Xiaolei,Li Jie,Xie Xinyu,Chang Weiwei,Ma Wensheng.. Meta-analysis of the long-term effect of maxillary protraction on jaw growth and development [J]. Int J Stomatol, 2022, 49(5): 548-555.
[5] Ma Yu,Zuo Yu,Zhang Xin. Photodynamic therapy as an adjunct to periodontitis: a meta-analysis [J]. Int J Stomatol, 2022, 49(3): 305-316.
[6] Zhou Wanhang,Li Yanfei,Xu Ricong,Wan Qijun. Effects of non-surgical periodontal treatment on risk factors of chronic kidney disease and systematic inflammatory levels in patients with chronic kidney disease and periodontal disease: a Meta-analysis [J]. Int J Stomatol, 2021, 48(5): 528-535.
[7] Qin Xiaoru,Liu Mengyuan. Association between periodontal disease and myocardial infarction: a Meta-analysis of cohort studies [J]. Int J Stomatol, 2021, 48(2): 165-172.
[8] Liu Ling,Gong Renguo,Dong Xiuhua,Liu Rumeng. Meta-analysis of the long-term stability of serious anterior skeletal open-bite malocclusion after orthodontic surgery [J]. Int J Stomatol, 2021, 48(2): 173-179.
[9] Wang Shiqi,Chang Yaqin,Chen Bin,Tan Baochun,Ni Yanhong. Comparison of clinical outcomes between using bone graft alone and the combination of bone graft with membrane for periodontal regeneration therapy: a systematic review and Meta-analysis [J]. Int J Stomatol, 2020, 47(6): 644-651.
[10] Hou Yali,Ma Li. Meta-analysis of the association between interferon regulatory factor 6 gene polymorphisms and non-syndromic cleft lip with or without cleft palate in Asian population [J]. Int J Stomatol, 2020, 47(4): 397-405.
[11] Gao Jie,Ma Rui,Ge Zhenlin. Effectiveness of heat-activated Ni-Ti wires for orthodontic treatment: a systematic review [J]. Int J Stomatol, 2019, 46(4): 393-399.
[12] Weilin Pan,Yubin Cao,Chang Liu,Jiyuan Liu,Chunjie Li,Jian Pan,Chengge Hua. Flap design associated pain after the extraction of mandibular third molars: a systematic review and Meta-analysis [J]. Inter J Stomatol, 2019, 46(2): 142-148.
[13] Li Tang, Li Chunjie, Men Yi, Yang Wenbin, Han Bo, Li Longjiang. Meta-analysis of pantomography for the diagnosis of mandibular invasion caused by oral cancers [J]. Inter J Stomatol, 2016, 43(1): 26-.
[14] Yang Wenbin, Li Chunjie, Men Yi, Han Bo, Li Longjiang, Pan Jian. A systematic review and Meta-analysis of effects of parotid masseteric fascia reservation on prevention of Frey’s syndrome [J]. Inter J Stomatol, 2013, 40(6): 730-735.
[15] Rao Nanquan, Chen E, Pei Jun, Xie Yunna.. Meta-analysis of the effectiveness of Vitapex in root canal therapy of deciduous teeth [J]. Inter J Stomatol, 2013, 40(2): 162-164.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
[1] . [J]. Foreign Med Sci: Stomatol, 1999, 26(06): .
[2] . [J]. Foreign Med Sci: Stomatol, 1999, 26(05): .
[3] . [J]. Foreign Med Sci: Stomatol, 1999, 26(05): .
[4] . [J]. Foreign Med Sci: Stomatol, 1999, 26(05): .
[5] . [J]. Foreign Med Sci: Stomatol, 1999, 26(05): .
[6] . [J]. Foreign Med Sci: Stomatol, 1999, 26(04): .
[7] . [J]. Foreign Med Sci: Stomatol, 2005, 32(06): 458 -460 .
[8] . [J]. Foreign Med Sci: Stomatol, 2005, 32(06): 452 -454 .
[9] . [J]. Inter J Stomatol, 2008, 35(S1): .
[10] . [J]. Inter J Stomatol, 2008, 35(S1): .