Peri-implant soft-tissue aesthetic outcome after immediate implant placement in conjunction with mucoderm® or CTG

Happe A, Schmidt A, Neugebauer J. (2022) J Esthet Restor Dent. Jan;34(1):215-225.
doi: 10.1111/jerd.12866. Epub 2022 Jan 18. PMID: 35043553.

Original Titel: Peri-implant soft-tissue esthetic outcome after immediate implant placement in conjunction with xenogeneic acellular dermal matrix or connective tissue graft: A randomized controlled clinical study


Evaluation of peri-implant soft tissue augmentation with mucoderm® in comparison to autologous soft tissue graft
The goal of the study was to compare the clinical performance of mucoderm® (porcine acellular dermal collagen matrix) with subepithelial CTG (connective tissue grafts) for peri-implant soft tissue augmentation with a focus on the mucosal color and the overall aesthetic appearance.


Implantation, soft tissue augmentation and aesthetic analysis in the anterior maxilla
20 patients underwent immediate implantation together with gap augmentation using xenogenic bone grafting material. For soft tissue augmentation, either hydrated mucoderm® or CTG obtained from the palate, were placed in a buccal pouch. A healing cap was applied, and the mucosa was adapted to cover the graft. 12 weeks after implantation, final restorations were applied and after 12 months measurements of the mean color differences (ΔE) of the buccal peri-implant mucosa compared to unrestored adjacent tooth were performed using a spectrophotometer and the Pink Aesthetic Score (PES, see Fig. 1) was evaluated.

Fig 1: The PES was measured by evaluating seven variables, each of which receives 0, 1 or 2 points.


Mucosal color and PES after 12 months

  • Similar mean color difference in both groups (ΔE 4.06 ± 1.6 for mucoderm® and ΔE 3.58 ± 1.36 mm for CTG; no statistically significant difference, p = 0.47)
  • Similar PES for both groups (11.4 ± 1.4 for mucoderm® and 10.7 ± 1.5 for CTG; no statistically significant difference, p = 0.29)
  • 100% implant osseointegration and success rate

Conclusion and clinical significance:

mucoderm® for soft tissue augmentation in conjunction with immediate implant placement has been demonstrated to be non-inferior to the gold standard as evidenced by a comparable aesthetic outcome one year after final delivery. Hence, shine-through effects and peri-implant soft-tissue color-mismatches can be reduced without autograft harvesting. In conclusion, mucoderm® offers the opportunity to simplify the treatment and avoid a second surgical procedure.

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