Immediate implant placement using tunneling technique with connective tissue graft versus coated and noncoated DuraGen matrix with concentrated growth factors

Abstract Background: Midfacial recession is a concern subsequent to immediate implant placement (IIP). Therefore, the application of connective tissue grafts (CTG) in conjunction with prompt implant placement and supply has shown encouraging outcomes. Objective: The purpose of this randomized controlled study is to assess clinically and radiographically the efficacy of CTG using tunnel technique simultaneous with flapless-guided IIP and provisional versus the dural graft effect alone or enhanced dural graft with concentrated growth factor in extraction socket type I with a thin mucosal thickness or thin facial bone thickness. Materials and methods: Twenty-four patients with extraction socket type I were enrolled in the present randomized controlled clinical trial. They were allocated randomly into IIP with the CTG group (group A), IIP using the dural graft group (group B), and treatment with IIP using coated dural graft with the concentrated growth factor group (group C). The assessment was made clinically by measuring facial soft tissue thickness at 3 mm, keratinized mucosal width, pink esthetic score, and radiographically facial bone thickness and marginal bone level. Results: However, intragroup comparison of median values in keratinized mucosal width, throughout follow up period of the three studied groups, showed statistically significant increase at 6 months compared to baseline value. The intergroup comparison showed that there was no-statistical significance between the three studied groups. Moreover, intragroup comparison of median values of marginal bone level through follow up, showed no statistically significant difference in median value in subepithelial CTG or in enhanced DuraGen, while there was statistically significant reduction in DuraGen matrix alone. In the intergroup comparison there was no-statistical significance reduction in all follow up periods in three studied groups. Conclusion: When it comes to soft tissue augmentation around implants, CTG is the gold standard. However, concentrated growth factor can be utilized as a legitimate substitute for CTG to lower patient morbidity because the improved xenogeneic dural graft results are quite similar to CTG. Trial registration: The trial is retrospectively registered at the Pan African Clinical Trial Registry with the identification number for the registry PACTR (202407826889857) 30/07/2024.