Effects of Oral and Maxillofacial Trauma on Soft Tissue Esthetic Outcomes of Dental Implants: A Systematic Review.

Oral and maxillofacial trauma frequently results in the loss of anterior teeth and disruption of the surrounding soft and hard tissues, creating significant challenges for implant rehabilitation in esthetically sensitive areas. Achieving stable peri-implant soft tissue contours is essential for long-term esthetic success, yet the influence of prior trauma on soft tissue outcomes remains unclear. This systematic review evaluated the impact of oral and maxillofacial trauma on esthetic soft tissue parameters following implant placement. Electronic searches of PubMed, Google Scholar, ScienceDirect, and the Cochrane Library were conducted up to May 2025 following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Five observational studies met the inclusion criteria, comprising a total of 163 patients treated predominantly in the anterior maxilla with immediate or delayed implant protocols. Soft tissue outcomes were assessed using parameters such as midfacial mucosal recession, papilla height, and the Pink Esthetic Score (PES). Overall, implants placed in traumatized sites demonstrated favorable esthetic results comparable to non-traumatized cases when appropriate bone augmentation, soft tissue management, and implant positioning were applied. Immediate placement with grafting provided stable soft tissue contours in post-traumatic cases, while long-term studies reported sustained soft tissue stability over 10 to 12 years. Despite positive outcomes, evidence remains limited by small sample sizes, heterogeneity in trauma types and assessment methods, and a lack of standardized aesthetic evaluation. Current findings suggest that oral and maxillofacial trauma does not inherently compromise soft tissue esthetic outcomes of implant therapy, though well-designed prospective studies are needed to clarify the role of trauma-related factors and optimize treatment protocols.