Influence of Timing on the Horizontal Stability of Connective Tissue Grafts for Buccal Soft Tissue Augmentation at Single Implants: A Prospective Controlled Pilot Study

J Oral Maxillofac Surg. 2019 Jun;77(6):1170-1179. doi: 10.1016/j.joms.2019.02.030. Epub 2019 Feb 26.


Purpose: The timing for soft tissue augmentation during implant therapy is still debated. Therefore, the present study clinically evaluated whether immediate versus delayed soft tissue augmentation procedures had an impact on the stability of peri-implant mucosal thickness (PMT).

Materials and methods: Patients requiring a single implant posterior to the canines in association with soft tissue augmentation procedures at the buccal aspect of single implants using a connective tissue graft (CTG) were enrolled. Patients were randomly allocated to 2 different timing protocols: simultaneous implant and CTG placement (test group) or implant placement and then CTG placement after 3 months (control group). PMT was measured clinically at the mid-buccal aspect of the implant site by bone sounding with an endodontic K-file using customized acrylic stents. PMT measurements were recorded before and after implant placement and at 1, 2, 3, 4, 6, 9, and 12 months after implant insertion. Parametric statistical tests were used to compare PMT between the test and control groups at each study period and to evaluate changes in PMT over time. The level of significance was set at a P value less than .05.

Results: Fourteen implants placed in 14 patients were available for statistical comparison. At 12 months, the difference in PMT between the test and control groups was 0.12 ± 0.51 mm. This difference was not statistically significant (P = .54). A significant increase in PMT was observed from baseline to 12 months after implantation in the test (P = .004) and control (P < .001) groups.

Conclusions: The present study indicated that changes in PMT after CTG placement were not influenced by the timing of soft tissue augmentation and remained stable up to 1 year after implant insertion.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Connective Tissue* / transplantation
  • Dental Implantation, Endosseous
  • Dental Implants*
  • Dental Implants, Single-Tooth*
  • Humans
  • Pilot Projects
  • Prospective Studies
  • Treatment Outcome


  • Dental Implants