Facial gingival level evaluation with and without connective tissue graft using tunnel technique on single immediate implants in the esthetic zone: A randomized controlled clinical trial

Aim The current study aimed to compare between immediate dental implants alone versus combined immediate dental implants with subepithelial connective tissue graft (SCTG) in the esthetic zone, and also to assess whether soft tissues augmentation could be an innovative option for reducing facial soft tissue recession.

Materials and methods In this parallel-designed RCT, a total of 18 participants were treated with single immediate post-extraction implants with SCTG placed using tunnel technique in the anterior and premolar areas (study group) and immediate implants treated without raising a flap and without SCTG (control group). Patients were observed with clinical parameters at baseline, 3- and 6-month follow-ups after implant placement. Data were analyzed using the ANOVA test to test the mean differences of the data that follow normal distribution and with repeated measures (between groups, within groups and overall difference).

Results After 6 months, facial gingival level changes were 3.72 mm ± 0.9 for the control group and 3.06 mm ± 0.9 for the study group, where the mean difference was 0.66 mm (95% CI, -0.53 to 1.85; P= 0.245). Regarding overall percentage change from baseline to 6 months, statistically significant differences were found between control group (25.17 ± 8.2) and study group (4.93 ± 0.2), mean difference was 20.63 (95% CI, 0.40 to 40.86; P= 0.054).

Conclusions With careful patient selection, the facial gingival level can be maintained after connective tissue grafting with single immediate implant placement.