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This state‐of‐the‐art review presents the latest evidence and the current status of autogenous soft tissue grafting for soft tissue augmentation and recession coverage at teeth and dental implant sites. The indications and predictability of the free gingival graft and connective tissue graft (CTG) techniques are highlighted, together with their expected clinical and esthetic outcomes. CTGs can be harvested from the maxillary tuberosity or from palate with different approaches that can have an impact on graft quality and patient morbidity. The influence of CTGs on soft tissue thickness and keratinized tissue width are also discussed.

The present article focuses on the properties and indications of scaffold‐based extracellular matrix (ECM) technologies as alternatives to autogenous soft tissue grafts for periodontal and peri‐implant plastic surgical reconstruction. The different processing methods for the creation of cell‐free constructs resulting in preservation of the extracellular matrices influence the characteristics and behavior of scaffolding biomaterials. The aim of this review is to discuss the properties, clinical application, and limitations of ECM‐based scaffold technologies in periodontal and peri‐implant soft tissue augmentation when used as alternatives to autogenous soft tissue grafts.

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