Trial reportClinical oral investigations2026
Clinical outcomes of free gingival graft, xenogeneic collagen matrix, and acellular dermal matrix for peri-implant keratinized mucosa augmentation: a randomized controlled trial.
Trial report in Clinical oral investigations, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesTo evaluate the effects of autologous free gingival graft (FGG), xenogeneic collagen matrix (XCM), and acellular dermal matrix (ADM) combined with apically positioned flap (APF) on buccal soft-tissue volume change and keratinized mucosa augmentation around dental implants. MATERIALS AND
methodsForty-four implants with buccal keratinized mucosa width (KMW) < 2 mm were randomly allocated to the FGG group, XCM group, or ADM group. The primary outcome was buccal soft-tissue volume change over a 12-month follow-up. Secondary outcomes included KMW, KMW shrinkage rate, mucosa thickness (MT), and peri-implant soft tissue health. Esthetic outcomes, postoperative pain, and patient satisfaction were further evaluated.
resultsNet buccal soft-tissue volume change decreased over time in all groups but remained significantly greater in the FGG group throughout follow-up. At 12 months, model-estimated net volume changes were 24.10 mm³ (95% CI: 2.69, 45.51) for FGG, 3.34 mm³ (- 19.77, 26.45) for XCM, and - 17.34 mm³ (- 40.45, 5.77) for ADM (P = 0.041), with FGG significantly exceeding ADM after Bonferroni adjustment. KMW decreased progressively in all groups, with no significant between-group differences at any time point. At 12 months, observed KMW was 2.93 ± 1.29 mm (FGG), 2.52 ± 0.51 mm (XCM), and 1.86 ± 0.82 mm (ADM). Using the immediately postoperative KMW as the reference, the 12-month KMW shrinkage rates were 56.25%, 61.44%, and 74.07%, respectively. FGG showed significantly greater mucosal thickness gain than ADM at 6 and 12 months (P < 0.05), while XCM did not differ significantly from either group. Esthetic outcomes, peri-implant parameters, patient satisfaction, and postoperative pain were comparable among groups (P > 0.05).
conclusionsFGG plus APF provided the most favorable maintenance of peri-implant buccal soft-tissue volume and thickness over 12 months. XCM showed intermediate performance, whereas ADM showed the greatest dimensional reduction. All three grafts showed stable peri-implant clinical parameters over 12 months, achieved acceptable esthetic outcomes, and yielded high patient satisfaction. CLINICAL RELEVANCE: For peri-implant soft-tissue augmentation with APF, FGG showed better maintenance of buccal soft-tissue volume and thickness than ADM over 12 months, while XCM showed intermediate performance. Graft selection should therefore consider the expected need for long-term dimensional stability.
trial registrationThis trial was registered in the Chinese Clinical Trial Registry with the registration number ChiCTR2100041688 ( https://www.chictr.org.cn/showproj.html?proj=66722 ) on January 1, 2021.
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