A randomized controlled study comparing guided bone regeneration with connective tissue graft to re-establish...

To compare guided bone regeneration (GBR) with connective tissue graft (CTG) to re-establish convexity at the buccal aspect of single implants.

Patients with a single tooth gap in the anterior maxilla and horizontal alveolar defect were enrolled in a single-blind randomized controlled trial. Sites had to demonstrate buccopalatal bone dimension of at least 6 mm prior to surgery to ensure complete embedding of an implant without the need for bone augmentation. All received a single implant and were randomly allocated to the control group (GBR) or the test group (CTG). Cross-sectional CBCT images at t₀ (before surgery), t₁ (2 weeks after surgery) and t₂ (1 year after surgery) were used to evaluate the buccal soft tissue profile (BSP). Secondary outcome variables were buccal bone thickness (BB), buccal soft tissue thickness (BST), vertical bone loss (VBL) and clinical parameters.

Twenty-one patients were included per group (control: 11 females, mean age: 51; test: nine females, mean age: 48). At t₂ , a significant increase in BSP between 0.7 and 1.5 mm was observed in each group (p ≤ 0.010). There was no significant difference between the groups at 1 year (p ≥ 0.126). The increase in BSP in the control group was basically the result of BB gain ranging from 0.69 to 1.15 mm. BSP gain in the test group was the result of an increase in BST ranging from 0.67 to 1.38 mm. VBL did not differ significantly between the groups (p ≥ 0.644). Implants demonstrated healthy clinical conditions with no significant differences between the groups for any of the parameters (p ≥ 0.095).

Within the limitations of superimposed CBCT images, GBR and CTG are effective to re-establish convexity at the buccal aspect of single implants in the short term.