A Three-arm Randomized Controlled Trial Comparing Transmucosal Augmentation Techniques in Immediate Implant Placement

What this Trial Is About

This research evaluates three different soft-tissue augmentation methods for patients receiving a single immediate implant placement in the front upper jaw (premaxilla). The study aims to find which method best prevents soft tissue loss around the implant one millimeter below the implant shoulder. It compares conventional connective tissue grafting with two newer techniques, scarf connective tissue graft and the dual zone concept, in a randomized controlled trial involving adults with good oral health. The study is led by University Ghent and involves 54 patients randomly assigned to one of the three treatment groups. All participants receive immediate implant placement combined with socket grafting. The three groups differ in their soft-tissue augmentation approach: the conventional method places a connective tissue graft inside a pouch on the buccal side; the scarf graft fixes a smaller tissue graft directly onto the buccal mucosa without a pouch; and the dual zone technique condenses bone material up to the soft tissue margin without using a connective tissue graft. After implant placement, a healing abutment is installed and replaced by a provisional crown two days later. Sutures are managed depending on the group and surgical needs. Participants are evaluated through cone-beam CT scans, clinical measurements, intra-oral scans, and photos at baseline and follow-ups at one and five years. The main outcome is successful regeneration measured by tissue maintenance at the specified level. Additional outcomes include bone loss, soft tissue thickness, patient pain reports, oral health indicators, and esthetic scores. Data analysis uses statistical tests to compare results across groups, with safety and esthetic results monitored over time.

Comparison of Three Transmucosal Augmentation Techniques in Immediate Implant Placement