The influence of different soft-tissue grafting procedures at single implant placement on esthetics: A randomized controlled trial

J Periodontol. 2018 Aug;89(8):903-914. doi: 10.1002/JPER.18-0061.


Background: Soft-tissue grafting to thicken the soft tissue around dental implants was proposed to ameliorate the esthetic outcome. Traditionally, connective tissue is used as a grafting material, but a xenogeneic collagen matrix was introduced as an alternative to reduce patient morbidity.

Methods: A total of 60 patients randomly received either no graft (n = 20, NG group), a connective tissue graft (n = 20, CTG group), or a xenogeneic collagen matrix (n = 20, XCM group) when an implant was placed in a preserved alveolar ridge. Changes in mid-buccal mucosal level (MBML) at 1 (T1 ) and 12 (T12 ) months after final implant crown placement were compared to the pre-extraction level. Additionally, esthetics, marginal bone level, clinical peri-implant parameters, and patient satisfaction were assessed.

Results: At T12 , mean changes in MBML were -0.48 ± 1.5 mm, -0.04 ± 1.1 mm, and -0.17 ± 1.3 mm in the NG, CTG, and XCM groups (P = 0.56), respectively. Regarding the other outcome variables, no significant intergroup differences were observed.

Conclusions: Soft-tissue grafting at single implant placement in preserved alveolar ridges does not result in a better esthetic outcome or in better peri-implant health and should not be considered as a standard procedure.

Keywords: alveolar ridge augmentation; connective tissue; esthetics; gingival recession; single-tooth implants.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Crowns
  • Dental Implantation, Endosseous
  • Dental Implants*
  • Dental Implants, Single-Tooth*
  • Esthetics, Dental
  • Humans
  • Treatment Outcome


  • Dental Implants

Associated data

  • NTR/NTR3815