Journal of clinical periodontology | 2021
A multicenter randomized controlled trial comparing connective tissue graft with collagen matrix to increase soft tissue thickness at the buccal aspect of single implants: 3-month results.
Abstract
AIM\nTo compare connective tissue graft (CTG) with collagen matrix (CMX) in terms of changes over time in buccal soft tissue profile (BSP) when applied at single implant sites.\n\n\nMATERIALS AND METHODS\nPatients with a single tooth gap in the anterior maxilla and horizontal mucosa defect were enrolled in a multicenter RCT. All sites had a bucco-palatal bone dimension of at least 6\u2009mm, received a single implant and immediate implant restoration using a full digital workflow and were randomly allocated to the control (CTG) or test group (CMX: Geistlich Fibro-Gide®, Geistlich Pharma AG, Wolhusen, Switzerland) to increase buccal soft tissue thickness. Primary outcome was increase in BSP at T1 (immediately postop) and T2 (3 months) based on superimposed digital surface models. Secondary parameters included patient-reported, clinical and esthetic outcomes.\n\n\nRESULTS\nThirty patients were included per group (control: 50% females, mean age 50; test: 53% females, mean age 48). Even though surgeons applied thicker grafts when using CMX, sites treated with CMX demonstrated 0.78\u2009mm (95% CI: 0.41 - 1.14) more shrinkage between T1 and T2 than sites treated with CTG. The final increase in BSP was 1.15\u2009mm (95% CI: 0.88 - 1.43) for CTG and 0.85\u2009mm (95% CI: 0.58 - 1.13) for CMX. The mean difference of 0.30\u2009mm (95% CI: -0.01 - 0.61) at T2 in favor of CTG was of borderline significance (p\xa0=\xa00.054). There were no significant differences between the groups in terms of postoperative bleeding (p\xa0=\xa00.344), pain (p\xa0=\xa00.331), number of analgesics taken (p\xa0=\xa00.504), edema (p\xa0=\xa00.227) and pink esthetic score (p\xa0=\xa00.655). VAS for postoperative hematoma was 6.56 (95% CI 0.54 - 12.59) lower for CMX and surgery time could be reduced by 9.03 min (95% CI: 7.04 - 11.03) when applying CMX. However, CMX resulted in significantly more marginal bone loss (0.38\u2009mm; 95% CI 0.15 - 0.60), deeper pockets (0.30\u2009mm; 95% CI 0.06 - 0.54) and more midfacial recession (0.75\u2009mm; 95% CI 0.39 - 1.12) than CTG.\n\n\nCONCLUSION\nCTG remains the gold standard for increasing soft tissue thickness at the buccal aspect of implants.