Peri-implant soft-tissue esthetic outcome after immediate implant placement in conjunction with xenogeneic acellular dermal matrix or connective tissue graft: A randomized controlled clinical study

Objectives This randomized comparative study evaluated the clinical esthetic outcome of the peri-implant mucosa following extraction and immediate implant placement in conjunction with anorganic bovine bone mineral (ABBM) and the use of a porcine acellular dermal matrix (pADM) versus an autogenous connective tissue graft (CTG) in the anterior maxilla. Materials and methods Twenty patients (11 men, 9 women) with a mean age of 48,9 years (range 21-72) were included in the study and randomly assigned to either the test (pADM) or control group (CTG). They underwent extraction and immediate implant placement together with ABBM for socket grafting and either pADM or CTG for soft tissue augmentation. Twelve months after implant placement color measurements of the peri-implant mucosa and a reference tooth were performed using a spectophotometer and the color difference (Delta E) was calculated. The overall esthetic appearance of the peri-implant soft tissue was evaluated using the Pink Esthetic Score (PES). Statistical analysis was performed using Student's T-Test, the alpha was set to 0.05. Results All implants received osseointegration and were restored. The mean color difference of the peri-implant mucosa 1 year after surgery amounted Delta E 4.06 +/- 1.6 for the test group (pADM) and Delta E 3.58 +/- 1.36 mm for the control group (CTG), showing no statistically significant difference (p = 0.47). The mean PES of the pADM group was 11.4 +/- 1.4 and for the CTG group 10.7 +/- 1.5, showing no statistically significant difference (p = 0.29). Conclusion Twelve months after surgery, a porcine acellular dermal matrix for soft tissue augmentation in conjunction with immediate implant placement showed no difference in the overall esthetic appearance regarding color match and Pink Esthetic Score in comparison to autogenous soft tissue graft. Clinical Significance Connective tissue grafts have become a standard in order to enhance the soft tissue quality and esthetic appearance in immediate implant placement. The use of new biomaterials like porcine acellular dermal matrices may avoid the need to harvest autogenous grafts resulting in simplified treatment and less postoperative morbidity.