This study aims to compare soft tissue grafting with acellular dermis at Phase I or Phase II dental implant surgery.

This proposed study would allow us to assess the use of two different timing protocols for soft tissue augmentation in real-world scenarios to improve clinicians' understanding of optimal protocols for soft tissue grafting and their impact on surgical outcomes, patient-reported outcomes, and long-term implant health.

Inclusion Criteria:

• English speaking
• At least 18 years old
• Must be a patient of the UAB Dental School
• Able to read and understand informed consent document
• Patients presenting with a single edentulous site planned for dental implant placement deemed deficient in soft tissue peri-implant phenotype (> 2mm width of keratinized tissue, < 1mm marginal soft tissue thickness, and/or > 2mm vertical soft tissue height)
• Presence of periodontally healthy, non-carious neighboring teeth and/or healthy restored dental implants on either side of edentulous site planned for dental implant placement.
• No anticipated need for surgical and/or endodontic care at teeth adjacent to the proposed surgical site during the study period.

Exclusion Criteria:

• Non-English speaking
• Less than 18 years old
• Smokers/tobacco users (>10 cigarettes/day)
• Patients with systemic pathologies or conditions contraindicating oral surgical procedures or adversely affecting wound healing
• Edentulous sites treatment planned for dental implant placement with adequate implant site soft tissue quality/quantity (> 2mm width of keratinized tissue, > 1mm marginal soft tissue thickness, and/or > 2mm vertical soft tissue height).
• Absence of adjacent teeth/implants on either side of the tooth to be extracted and/or edentulous sites where 2 or more adjacent implants are planned.

Data from this study will not be shared with other researchers outside of our research team.