Aumento de tejido blando peri-implantario. ¿Qué momento temporal y técnica quirúrgica debo emplear para conseguir que mis resultados sean predecibles? Revisión de la literatura

Resumo

The role of an adequate width of keratinized mucosa (KM) around dental implants in the long-term stability of peri-implant tissues is still controversial. The aim of this study was to evaluate and describe the results of the surgical techniques available and the moment in which the increase of the peri-implant soft tissues should take place. An electronic bibliographic search was carried out in the PubMed and Medline databases, considering the period between 2012 and 2017 and including those articles that dealt with different surgical techniques performed from time B (from the implants fitting). A total of 10 articles were included, comparing them according to the time when the surgical technique was performed and analyzing the following study variables: width of keratinized mucosa, thickness of keratinized mucosa, postoperative contraction, surgical and aesthetic time and postoperative discomfort. It can be concluded that the free gingival graft has been shown to obtain the largest widths of keratinized mucosa. However, there are other materials available that reduce the morbidity of the patient and avoid a second surgical site such as the xenogeneic collagen matrix which can be as effective and predictable as the free gingival graft. Both the xenogeneic collagen matrix and the connective tissue graft offer superior aesthetic results to those obtained with the free gingival graft.