The use of connective-tissue grafts (CTG) alongside immediate implant placement has been advocated as a way of tackling one of the main aesthetic complications of this procedure – mid-facial recession of the buccal gingival margin.
The idea is that the graft compensates for the volumetric contraction of the alveolar process and prevents the apical migration of the gingival margin.
A randomised controlled clinical trial carried out at Peking University in Beijing, China, investigated the adjunctive effects of a CTG on soft and hard tissues during immediate implant placement and provisionalisation (IIPP), over a healing period of six months.
Summarised as JCP Digest issue number 80, the research found that the adjunctive use of a CTG with a flapless IIPP protocol is a suitable means to sustain the buccal-tissue profile in a submarginal position, but no impact was observed in the first millimetre apical to the gingival margin. In addition, the adjunctive use of a CTG had no impact on the hard-tissue remodelling of the socket.
Researchers concluded that, when delivering an IIPP in the anterior maxilla, the adjunctive use of a CTG allows the reduction of the buccal collapse of soft tissue at the submarginal level.
Nonetheless, they said that a minor recession of the gingival margin and a collapse of the gingival profile in its most coronal millimetre should be expected.
The research was summarised for JCP Digest by students of the postgraduate programme in periodontology at the Complutense University of Madrid in Spain.