Buccal Graft + Collagen Matrix Versus Free Gingival Graft for Keratinized Mucosa Augmentation at Implant Sites

Buccal Strip Gingival Graft With a Xenogeneic Collagen Matrix Versus Free Gingival Graft for Keratinized Mucosa Augmentation at Implant Sites: A Randomized, Controlled, Clinical Trial

The study aims at comparing two different approaches for soft tissue augmentation at implants lacking keratinized and adherent mucosa width: the free gingival graft (FGG) vs the Buccal Strip Graft in combination with a xenogeneic collagen matrix (BSG + CM)

Conventional free gingival graft (FGG), serving as control group, will be compared to buccal strip gingival graft (BSG) in combination with a collagen matrix (CM), serving as test group, in terms of clinical, volumetric, ultrasonographic, and patient-reported outcomes related to soft tissue augmentation at implant sites lacking keratinized and adherent mucosa.

Inclusion Criteria:

• Age ≥ 18 years,
• Periodontally and systemically healthy,
• Full-mouth plaque score and full-mouth bleeding ≤ 20% (measured at four sites per tooth),
• Presence of at least one dental implant with < 2 mm of KM and lack of firm/adherent mucosa,
• Presence of at least 4 mm of keratinized gingiva in two or more teeth nonadjacent to the implant to be treated,
• Implants diagnosed as healthy (Berglundh et al. 2018),
• The patient must be able to perform good oral hygiene.

Exclusion criteria:

• Contraindications for surgery,
• Systemic condition (e.g. diabetes mellitus, HIV, cancer, etc) that could compromise wound healing,
• Patients pregnant or attempting to get pregnant (self-reported),
• Untreated periodontitis,
• Untreated peri-implant mucositis or peri-implantitis (Berglundh et al. 2018),
• Smoking,
• Allergy to collagen-based medical products or iodine,
• Previous free gingival graft procedure at the target site.