Evaluation of Coronal Soft Tissue Regeneration With Bovine Collagen Matrix Augmentation Over an Immediate Implant: A Randomized Controlled Trial

Aim: This study aims to evaluate the use of augmented bovine-derived collagen to regenerate coronal soft tissue at the time of immediate implant placement in the aesthetic zone. Materials and methods: Thirty-six individuals who underwent immediate implant placement from December 2024 to July 2025 were split at random into two groups. For Group I, a split-thickness flap was created, and a bovine collagen matrix was left coronally placed and sutured to the mucosa. For Group II, a full-thickness coronally repositioned flap was reflected and sutured to the mucosa. The clinical effectiveness of this collagen membrane, as measured by the volume of soft tissue (VST) regenerated and covered over the coronal surface of the implant, was evaluated by comparing the VST preoperatively after extraction (T0) and at the third postoperative month (T1) using an endodontic reamer and color map analysis. The effectiveness of collagen by means of epithelialization and granulation tissue formation at T1 was measured by performing a punch biopsy. Histologically, at T1, the nature of the regenerated soft tissue at the coronal part of the implant was compared with its native tissue. Results: The clinical outcome results proved that Group I showed significant results with respect to VST, epithelialization, and granulation tissue formation. This difference shows that it is statistically significant (t=6.39; p=0.001), suggesting a better outcome in Group I than Group II. Histologically, Group I and Group II showed normal epithelization of their native tissue without any presence of inflammatory or granulation tissue. Conclusion: The clinical outcome results proved that the bovine-derived collagen membrane showed significant results and could be used as an alternative to the coronally advanced flap.