title: Implant associated soft tissue defects in the anterior maxilla: a randomized control trial comparing subepithelial connective tissue graft and acellular dermal matrix allograft.
abstract: BACKGROUND
  This randomized controlled clinical pilot trial compared the efficacy of 2 soft tissue grafting methods for correcting esthetic discrepancies associated with definitively restored implant crowns.
  
  
  METHODS
  Thirteen patients presenting with implants displaying recession, thin biotype, concavity defects, or a combination thereof associated with single crowned dental implants randomly received subepithelial connective tissue grafts (SCTG) in the control group (N = 7) or acellular dermal matrix (ADM) allografts in the test group (N = 6), both under coronally positioned flaps. Data regarding soft tissue, hard tissue, esthetics, and quality of life (QoL) parameters were collected over 6 months.
  
  
  RESULTS
  Both groups gained tissue thickness (SCTG: 63% and ADM: 105%), reduced concavity measures (SCTG: 82% and ADM: 96%), and improved recessions (SCTG: 40% and ADM: 28%) from baseline to 6 months. Clinicians determined improvement in esthetics for both groups (P = 0.001), unlike patients who did not change their esthetic ratings. No statistical differences were noted for QoL assessment; however, ADM subjects had more eventful wound healing (P = 0.021).
  
  
  CONCLUSIONS
  Within the limitations of this study, both SCTG and ADM result in increased mucosal thickness, reduction in concavity dimensions, and have a potential for recession reduction on definitively restored dental implants.
authors.affiliation: *Currently, Private Practice, Ann Arbor, MI; Previously, Graduate Periodontics, Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI. †Associate Professor of Dentistry, Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI; Department of Psychology, College of Literature, Science and Arts, University of Michigan, Ann Arbor, MI. ‡Clinical Assistant Professor, Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI. §Professor and Director of Graduate Periodontics, Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI.
authors.forename: Lauren E
authors.initials: LE
authors.lastname: Anderson
authors.forename: Marita R
authors.initials: MR
authors.lastname: Inglehart
authors.forename: Karim
authors.initials: K
authors.lastname: El-Kholy
authors.forename: Robert
authors.initials: R
authors.lastname: Eber
authors.forename: Hom-Lay
authors.initials: HL
authors.lastname: Wang
mesh_terms: D062088:Acellular Dermis; D003238:Connective Tissue / Q000637:transplantation*; D015921:Dental Implants; D006801:Humans; D008437:Maxilla / Q000473:pathology*; D010865:Pilot Projects; D019737:Transplants
chemical_list: D015921:Dental Implants