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Buccal Graft + Collagen Matrix Versus Free Gingival Graft for Keratinized Mucosa Augmentation at Implant Sites

Not Applicable
Active, not recruiting
Conditions
Surgery
Interventions
Procedure: Conventional Free Gingival Graft Approach (FGG)
Procedure: Buccal Strip Graft with a collagen matrix (bSG + CM)
Registration Number
NCT05844475
Lead Sponsor
Harvard Medical School (HMS and HSDM)
Brief Summary

The study aims at comparing two different approaches for soft tissue augmentation at implants lacking keratinized and adherent mucosa width: the free gingival graft (FGG) vs the Buccal Strip Graft in combination with a xenogeneic collagen matrix (BSG + CM)

Detailed Description

Conventional free gingival graft (FGG), serving as control group, will be compared to buccal strip gingival graft (BSG) in combination with a collagen matrix (CM), serving as test group, in terms of clinical, volumetric, ultrasonographic, and patient-reported outcomes related to soft tissue augmentation at implant sites lacking keratinized and adherent mucosa.

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
32
Inclusion Criteria
  • Age ≥ 18 years,
  • Periodontally and systemically healthy,
  • Full-mouth plaque score and full-mouth bleeding ≤ 20% (measured at four sites per tooth),
  • Presence of at least one dental implant with < 2 mm of KM and lack of firm/adherent mucosa,
  • Presence of at least 4 mm of keratinized gingiva in two or more teeth nonadjacent to the implant to be treated,
  • Implants diagnosed as healthy (Berglundh et al. 2018),
  • The patient must be able to perform good oral hygiene.

Exclusion criteria:

  • Contraindications for surgery,
  • Systemic condition (e.g. diabetes mellitus, HIV, cancer, etc) that could compromise wound healing,
  • Patients pregnant or attempting to get pregnant (self-reported),
  • Untreated periodontitis,
  • Untreated peri-implant mucositis or peri-implantitis (Berglundh et al. 2018),
  • Smoking,
  • Allergy to collagen-based medical products or iodine,
  • Previous free gingival graft procedure at the target site.
Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Free gingival graft (FGG)Conventional Free Gingival Graft Approach (FGG)Conventional free gingival graft, involving the harvesting of an epithelialized graft from the hard palate, which is then stabilized/sutured to the recipient site (implant).
Buccal Strip Graft + Collagen matrix (bSG + CM)Buccal Strip Graft with a collagen matrix (bSG + CM)Strip graft obtained from the buccal mucosa of a site showing abundant keratinized gingiva, combined with a collagen matrix. The bSG + CM graft is stabilized/sutured to the recipient site (implant).
Primary Outcome Measures
NameTimeMethod
Sites showing KM≥ 2 mm and AM≥ 1 mm6 and 12 months

Number of sites showing at least 2 mm of keratinized mucosa width (in millimeters) and at least of 1 mm of attached mucosa (in millimeters) (outcome expressed as a number)

Secondary Outcome Measures
NameTimeMethod
Volumetric change6 and 12 months

Volumetric change occurring at the treated sites analyzed by superimposing digital impressions obtained using optical scanners at baseline and 6 months (expressed in mm\^3)

KM width gain6 and 12 months

Gain in keratinized mucosa width obtained after the intervention compared to baseline (expressed in millimeters)

Esthetic assessmentBaseline and 12 months

Patient-reported outcome assessed with questionnaire including a 0-100 visual analogue scale (VAS) at the initial and last visit (expressed as a number)

Post-operative morbidityDaily, for the first 4 weeks after the procedure

Patient-reported outcome assessed using a daily questionnaire first the first 4 weeks (expressed as a number using a 0-100 visual analogue scale \[VAS\])

Ultrasonographic strain elastographyBaseline, 3 months, 6 months and 12 months

Changes in the elasticity of the soft tissue over the healing assessed with ultrasonography (expressed as a ratio)

AM gain6 and 12 months

Gain in attached mucosa width obtained after the intervention compared to baseline (expressed in millimeters)

Ultrasonographic tissue perfusionBaseline, 1 week, 2 weeks, 1 month, 3 months, 6 months and 12 months

Tissue perfusion changes over the healing assessed with ultrasonography (expressed in cm/s)

Treatment satisfaction12 months

Patient-reported outcome assessed with questionnaire including a 0-100 visual analogue scale (VAS) at the last visit (expressed as a number)

Mucosal thickness (MT) gain6 and 12 months

Gain of mucosal thickness (MT) obtained after the intervention compared to baseline (expressed in millimeters)

Trial Locations

Locations (1)

Harvard School of Dental Medicine

🇺🇸

Boston, Massachusetts, United States

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