Randomized controlled pilot study comparing small buccal defects around dental implants treated with a subepithelial connective tissue graft or with guided bone regeneration

Abstract

AimTo compare subepithelial connective tissue grafts (SCTG) versus guided bone regeneration (GBR) for the treatment of small peri‐implant dehiscence defects in terms of profilometric (primary outcome), clinical, and patient‐reported outcome measures (PROMs).MethodsSixteen patients who presented with small buccal bone dehiscences (≤3 mm) following single implant placement were recruited. Following implant placement, buccal bone defect sites were randomly treated either with a SCTG or GBR. Six patients who lacked bone dehiscences after implant placement were assigned to a negative control. Transmucosal healing was applied in all patients. Patients were examined prior (T1) and after (T2) implant placement, at suture removal (T3), at implant impression (T5), at crown delivery (T6), and 12 (T7) months after crown delivery. Measurements included profilometric outcomes, marginal bone levels, buccal bone and soft tissue thickness, PROMs, and clinical parameters. All data were analyzed descriptively.ResultsThe median changes in buccal contour as assessed by profilometric measures between T1 and T5 showed a decrease of 1.84 mm for the SCTG group and 1.06 mm for the GBR group. Between T2 and T7, the median change in the buccal contour amounted to 0.45 mm for SCTG and −0.94 mm (=loss) for GBR. Patients' pain perception tended to be higher in SCTG than in GBR. All peri‐implant soft tissue parameters showed healthy oral tissues and no clinically relevant differences between groups.ConclusionWithin the limitations of this pilot study, treating small peri‐implant dehiscence defects with a SCTG might be a viable alternative to GBR. The use of a SCTG tended to result in more stable profilometric outcomes and comparable clinical outcomes to GBR. However, patient‐reported outcome measures tended to favor GBR.

The use of digital technologies in peri‐implant soft tissue augmentation – A narrative review on planning, measurements, monitoring and aesthetics

“…However, regardless of the specific scanning technology or IOS system used, IOSs offer a reliable alternative for obtaining virtual diagnostic casts with accuracy comparable to conventional impression methods (Kong et al, 2022;Revilla-Leon et al, 2020). Although IOS systems were originally developed for digital impressions of teeth, implants and the surrounding soft tissue (Benic et al, 2015), they are now increasingly popular for assessing 3D changes in soft tissue contour (Avila-Ortiz et al, 2023;Strauss et al, 2022;Zuercher et al, 2023).…”