Horizontal stability of connective tissue grafts at the buccal aspect of single implants: a 1-year prospective case series

Thomas De Bruyckere, Aryan Eghbali, Faris Younes, Hugo De Bruyn, Jan Cosyn

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52 Citations (Scopus)


Aim: To clinically evaluate the horizontal stability of a connective tissue graft
(CTG) at the buccal aspect of single implants (1); to compare actual gingival
thickness between thin and thick gingival biotype (2).
Materials and Methods: Periodontally healthy non-smoking patients with a single
implant in the anterior maxilla (15–25) were selected for a prospective case series.
All demonstrated a horizontal alveolar defect and were in need of contour
augmentation by means of CTG for aesthetic reasons. Patients were enrolled
3 months after implant surgery and had been provided with a provisional screwretained
crown. CTG was inserted in the buccal mucosa via the envelope technique
using one intrasulcular incision. An ultrasonic device was used to evaluate
mucosal thickness (MT) at the buccal aspect. MT was assessed at t0 (before
CTG), t1 (immediately after CTG), t2 (2 weeks after CTG = suture removal), t3
(3 months after CTG = permanent crown installation) and t4 (1 year after
implant placement). The gingival biotype was categorized as thin or thick based
on the transparency of a periodontal probe through the soft tissues while probing
the buccal sulcus of the contra-lateral tooth. Gingival thickness (GT) was measured
at the contra-lateral tooth using the same ultrasonic device.
Results: Thirty-seven patients (19 men, 18 women; mean age 38) met the selection
criteria and consented to the treatment. Mean soft tissue gain immediately after
CTG was on average 1.07 mm (SD 0.49). What remained of this tissue gain after
1 year was on average 0.97 mm (SD 0.48; 90.5%). Hence, mean soft tissue loss
amounted to 0.10 mm (SD 0.23; 9.5%; p = 0.015) with no significant difference
between patients with a thin or thick biotype (p ≥ 0.290). Patients with a thin
biotype had a mean GT of 1.02 mm (SD 0.21), whereas GT was on average
1.32 mm (SD 0.31) in subjects with a thick biotype (p = 0.004).
Conclusion: Connective tissue graft substantially thickens
Original languageEnglish
Pages (from-to)876-882
Number of pages7
JournalJournal of Clinical Periodontology
Issue number9
Publication statusPublished - 1 Sep 2015


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