Fgg/Xcm/Adm For Augmenting Kmw Around Implants: A Rct

To evaluate the clinical efficacy of autologous free gingival graft (FGG), xenogeneic collagen matrix (XCM), and acellular dermal matrix (ADM) combined with apically positioned flap (APF) in augmenting peri-implant keratinized mucosa width (KMW). The study enrolled 13 patients (1 male, 12 females; age range 21–65 years) who were approved by the Ethics Committee of the School and Hospital of Stomatology, Shandong University. Thirty-six implants with buccal KMW ≤ 2 mm were randomized into FGG, XCM, or ADM groups, and assessed over 12 months for KMW, shrinkage, mucosal thickness (MT) and volume. Linear MT measurements and 3D volumetric assessments were performed using reverse engineering software via digital measurement techniques. At 12 months post-surgery, FGG exhibited the best KMW retention (52% shrinkage rate), followed by XCM (63%), with ADM showing the lowest retention (73%). The FGG group demonstrated the highest mean MT and volume gains (0.39±0.40 mm and 22.31±15.64 mm³), while the XCM and ADM groups exhibited smaller gains. The ICC for linear MT and 3D volume measurements using intraoral scanners were 0.997 and 0.982, indicating excellent reliability. This study found that FGG, XCM, and ADM all significantly increased peri-implant KMW, with FGG demonstrating the best clinical results. Digital measurements of MT and volumetric differences revealed significant variations, with FGG showing better outcomes than XCM and ADM.