Comparison of acellular dermal matrix allografts and connective tissue autografts in soft-tissue augmentation around...

Immediate implant has multiple advantages but does not prevent the reduction in dimension of the labial cortical plate due to bone remodelling and soft-tissue collapse along with gingival recession. This Randomised Controlled Trial (RCT) was carried out to evaluate the changes in peri-implant soft-tissue dimensions after the immediate implant along with soft-tissue augmentation with acellular dermal matrix and connective tissue autografts.

Twenty clinical cases requiring tooth extraction in the anterior region of the maxilla (single rooted tooth) were selected and randomly divided. An immediate implant with soft-tissue augmentation with acellular dermal matrix (group A) and connective tissue autografts (group B) was carried out. Clinical parameters such as thickness of the marginal gingiva (mm), width of the keratinized mucosa (KMW) (mm), dimensions of the interdental papilla between the implant and the adjacent teeth (mesial and distal) and gingival biotype around the implant at the baseline (before extraction of the tooth) and at 180 days (after implant placement during second-stage surgical exposure) were evaluated.

The mean postoperative gingival thickness and KMW were statistically higher in group B than in group A. There was statistically significant intragroup decrease in papillary height in both the groups; however, intergroup change was insignificant. In both the groups, there was an increase in thickness of gingival tissue, but the gingival biotype remained thin.

Immediate implants augmented with connective tissue autografts showed an increase in thickness of the gingiva and KMW, reduced papillary collapse and improvement in tissue biotype as compared with the acellular dermal matrix.