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A multi‐centre randomized controlled trial comparing connective tissue graft with collagen matrix to increase soft tissue thickness at the buccal aspect of single implants : 3‐month results

Jan Cosyn (UGent) , Célien Eeckhout (UGent) , Véronique Christiaens (UGent) , Aryan Eghbali (UGent) , Stijn Vervaeke (UGent) , Faris Younes (UGent) and Thomas De Bruyckere (UGent)
(2021) JOURNAL OF CLINICAL PERIODONTOLOGY. 48(12). p.1502-1515
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Abstract
Aim To compare connective tissue graft (CTG) with collagen matrix (CMX) in terms of changes over time in buccal soft tissue profile (BSP) when applied at single implant sites. Materials and methods Patients with a single tooth gap in the anterior maxilla and horizontal mucosa defect were enrolled in a multi-centre randomized controlled trial. All sites had a bucco-palatal bone dimension of at least 6 mm and received a single implant and immediate implant restoration using a full digital workflow. Sites were randomly allocated to the control (CTG) or test group (CMX: Geistlich Fibro-Gide (R), Geistlich Pharma AG, Wolhusen, Switzerland) to increase buccal soft tissue thickness. Primary outcome was increase in BSP at T1 (immediately after operation) and T2 (3 months) based on superimposed digital surface models. Secondary parameters included patient-reported clinical and aesthetic outcomes. Results Thirty patients were included per group (control: 50% females, mean age 50; test: 53% females, mean age 48). Even though surgeons applied thicker grafts when using CMX, sites treated with CMX demonstrated 0.78 mm (95% CI 0.41-1.14) more shrinkage between T1 and T2 than sites treated with CTG. The final increase in BSP was 1.15 mm (95% CI 0.88-1.43) for CTG and 0.85 mm (95% CI 0.58-1.13) for CMX. The mean difference of 0.30 mm (95% CI -0.01 to 0.61) at T2 in favour of CTG was of borderline significance (p = .054). There were no significant differences between the groups in terms of post-operative bleeding (p = .344), pain (p = .331), number of analgesics taken (p = .504), oedema (p = .227), and pink aesthetic score (p = .655). VAS for post-operative haematoma was 6.56 (95% CI 0.54-12.59) lower for CMX, and surgery time could be reduced by 9.03 min (95% CI 7.04-11.03) when applying CMX. However, CMX resulted in significantly more marginal bone loss (0.38 mm; 95% CI 0.15-0.60), deeper pockets (0.30 mm; 95% CI 0.06-0.54), and more mid-facial recession (0.75 mm; 95% CI 0.39-1.12) than CTG. Conclusions CTG remains the gold standard for increasing soft tissue thickness at the buccal aspect of implants.
Keywords
Periodontics, collagen matrix, connective tissue graft, dental implant, single tooth, AUGMENTATION, OUTCOMES

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MLA
Cosyn, Jan, et al. “A Multi‐centre Randomized Controlled Trial Comparing Connective Tissue Graft with Collagen Matrix to Increase Soft Tissue Thickness at the Buccal Aspect of Single Implants : 3‐month Results.” JOURNAL OF CLINICAL PERIODONTOLOGY, vol. 48, no. 12, 2021, pp. 1502–15, doi:10.1111/jcpe.13560.
APA
Cosyn, J., Eeckhout, C., Christiaens, V., Eghbali, A., Vervaeke, S., Younes, F., & De Bruyckere, T. (2021). A multi‐centre randomized controlled trial comparing connective tissue graft with collagen matrix to increase soft tissue thickness at the buccal aspect of single implants : 3‐month results. JOURNAL OF CLINICAL PERIODONTOLOGY, 48(12), 1502–1515. https://doi.org/10.1111/jcpe.13560
Chicago author-date
Cosyn, Jan, Célien Eeckhout, Véronique Christiaens, Aryan Eghbali, Stijn Vervaeke, Faris Younes, and Thomas De Bruyckere. 2021. “A Multi‐centre Randomized Controlled Trial Comparing Connective Tissue Graft with Collagen Matrix to Increase Soft Tissue Thickness at the Buccal Aspect of Single Implants : 3‐month Results.” JOURNAL OF CLINICAL PERIODONTOLOGY 48 (12): 1502–15. https://doi.org/10.1111/jcpe.13560.
Chicago author-date (all authors)
Cosyn, Jan, Célien Eeckhout, Véronique Christiaens, Aryan Eghbali, Stijn Vervaeke, Faris Younes, and Thomas De Bruyckere. 2021. “A Multi‐centre Randomized Controlled Trial Comparing Connective Tissue Graft with Collagen Matrix to Increase Soft Tissue Thickness at the Buccal Aspect of Single Implants : 3‐month Results.” JOURNAL OF CLINICAL PERIODONTOLOGY 48 (12): 1502–1515. doi:10.1111/jcpe.13560.
Vancouver
1.
Cosyn J, Eeckhout C, Christiaens V, Eghbali A, Vervaeke S, Younes F, et al. A multi‐centre randomized controlled trial comparing connective tissue graft with collagen matrix to increase soft tissue thickness at the buccal aspect of single implants : 3‐month results. JOURNAL OF CLINICAL PERIODONTOLOGY. 2021;48(12):1502–15.
IEEE
[1]
J. Cosyn et al., “A multi‐centre randomized controlled trial comparing connective tissue graft with collagen matrix to increase soft tissue thickness at the buccal aspect of single implants : 3‐month results,” JOURNAL OF CLINICAL PERIODONTOLOGY, vol. 48, no. 12, pp. 1502–1515, 2021.
@article{8735241,
  abstract     = {{Aim To compare connective tissue graft (CTG) with collagen matrix (CMX) in terms of changes over time in buccal soft tissue profile (BSP) when applied at single implant sites. Materials and methods Patients with a single tooth gap in the anterior maxilla and horizontal mucosa defect were enrolled in a multi-centre randomized controlled trial. All sites had a bucco-palatal bone dimension of at least 6 mm and received a single implant and immediate implant restoration using a full digital workflow. Sites were randomly allocated to the control (CTG) or test group (CMX: Geistlich Fibro-Gide (R), Geistlich Pharma AG, Wolhusen, Switzerland) to increase buccal soft tissue thickness. Primary outcome was increase in BSP at T1 (immediately after operation) and T2 (3 months) based on superimposed digital surface models. Secondary parameters included patient-reported clinical and aesthetic outcomes. Results Thirty patients were included per group (control: 50% females, mean age 50; test: 53% females, mean age 48). Even though surgeons applied thicker grafts when using CMX, sites treated with CMX demonstrated 0.78 mm (95% CI 0.41-1.14) more shrinkage between T1 and T2 than sites treated with CTG. The final increase in BSP was 1.15 mm (95% CI 0.88-1.43) for CTG and 0.85 mm (95% CI 0.58-1.13) for CMX. The mean difference of 0.30 mm (95% CI -0.01 to 0.61) at T2 in favour of CTG was of borderline significance (p = .054). There were no significant differences between the groups in terms of post-operative bleeding (p = .344), pain (p = .331), number of analgesics taken (p = .504), oedema (p = .227), and pink aesthetic score (p = .655). VAS for post-operative haematoma was 6.56 (95% CI 0.54-12.59) lower for CMX, and surgery time could be reduced by 9.03 min (95% CI 7.04-11.03) when applying CMX. However, CMX resulted in significantly more marginal bone loss (0.38 mm; 95% CI 0.15-0.60), deeper pockets (0.30 mm; 95% CI 0.06-0.54), and more mid-facial recession (0.75 mm; 95% CI 0.39-1.12) than CTG. Conclusions CTG remains the gold standard for increasing soft tissue thickness at the buccal aspect of implants.}},
  author       = {{Cosyn, Jan and Eeckhout, Célien and Christiaens, Véronique and Eghbali, Aryan and Vervaeke, Stijn and Younes, Faris and De Bruyckere, Thomas}},
  issn         = {{0303-6979}},
  journal      = {{JOURNAL OF CLINICAL PERIODONTOLOGY}},
  keywords     = {{Periodontics,collagen matrix,connective tissue graft,dental implant,single tooth,AUGMENTATION,OUTCOMES}},
  language     = {{eng}},
  number       = {{12}},
  pages        = {{1502--1515}},
  title        = {{A multi‐centre randomized controlled trial comparing connective tissue graft with collagen matrix to increase soft tissue thickness at the buccal aspect of single implants : 3‐month results}},
  url          = {{http://doi.org/10.1111/jcpe.13560}},
  volume       = {{48}},
  year         = {{2021}},
}

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