The comparison of acellular dermal matrix allografts with free gingival grafts in the augmentation of peri-implant attached mucosa: a randomised controlled trial.
OBJECTIVE
The purpose of this randomised controlled trial is to compare the efficacy of two techniques for enhancing peri-implant keratinised mucosa: acellular dermal matrix allograft versus free gingival grafts.


METHODS
Thirty-six patients having implant sites with less than 1.5 mm of keratinised mucosa width were randomly assigned to two groups. Thirty-six implants placed in 18 patients received acellular dermal matrix allografts (ADM group), while 36 implants placed in 18 individuals received free gingival grafts (FGG group). Plaque index (PI), gingival index (GI), probing depth (PD) and the width of attached mucosa (WAM) were measured at baseline and at 1, 3 and 6 months following surgery.


RESULTS
WAM in the FGG group was significantly greater than the ADM group at 3 (P = 0.026) and 6 months (P < 0.001). In the FGG group, final gain of WAM was greater (1.58 mm in ADM group, 2.57 mm in FGG group) (P < 0.001) and postoperative relapse was smaller (2.68 mm in the ADM group, 1.73 mm in the FGG group) (P < 0.001). PI and GI scores were greater in the ADM group at 6 months (P = 0.016 and P = 0.61, respectively). The FGG group demonstrated a greater PD value at 3 months (P < 0.001), however there was no significant difference between the groups at 6 months (P = 0.317).


CONCLUSIONS
Although ADM allografts are capable of increasing the width of peri-implant keratinised mucosa, FGGs seem to be more effective. ADM allografts may be the application of choice at implant sites in need of major grafts and in patients where a donor site should be avoided for medical or psychological reasons.
Istanbul University, Department of Oral Implantology, Istanbul, Turkey. cansu.basegmez@gmail.com
Cansu
C
Basegmez
Zihni Cuneyt
ZC
Karabuda
Korkud
K
Demirel
Serdar
S
Yalcin
D062088:Acellular Dermis; D015921:Dental Implants; D003774:Dental Plaque Index; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D005881:Gingiva / Q000473:pathology / Q000637:transplantation*; D005893:Gingivoplasty / Q000379:methods*; D006801:Humans; D007633:Keratins; D008297:Male; D008875:Middle Aged; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000145:classification; D012008:Recurrence; D016038:Skin Transplantation; D014184:Transplantation, Homologous; D016896:Treatment Outcome
D015921:Dental Implants; D007633:Keratins