Comparison of dental procedures for enhancing keratinized mucosa around dental implants

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Created On: 24/04/2025

To study the long-term effectiveness of two methods—collagen matrix (CM) and free gingival graft (FGG)—to enhance keratinized mucosa around posterior dental implants, tracking the results over 5 years.

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Key take away

For long-term benefits, free gingival graft is preferred over collagen matrix for augmenting mucosal tissue around dental implants due to its superior stability and lower tissue shrinkage.

Background

Method

This randomized controlled trial comprised 30 patients (44 implants) with less than 2 mm of keratinized mucosa who were randomly split into two groups. One group received KM augmentation with CM, while the other undertook FGG.

Over the next five years, clinical measures like keratinized mucosa width, buccal mucosal thickness, and other key parameters were taken. Radiographs were used to assess marginal bone loss, and patients reported their satisfaction both one week and five years after surgery.

Result

Both methods showed a notable increase in keratinized mucosa width over time, but FGG consistently outperformed CM, especially in the first few months. By the five-year mark, the FGG group had less keratinized mucosa shrinkage (47%) compared to CM (70%)—a substantial difference.

While both groups saw a boost in mucosal thickness, the FGG group had more substantial gains. Interestingly, although bleeding scores were higher for FGG in the first two days, overall patient satisfaction remained high across both groups at the designed follow-up.

Conclusion

FGG technique excelled in both keratinized mucosa augmentation and mucosal thickness. CM showed no noteworthy benefits in patient-reported outcomes, aside from a slight difference in self-reported bleeding in the first two days following surgery.