The Effect of Connective Tissue Grafting on Soft Tissue Dimensional Changes After Immediate Implant Placement and Provisionalization: A Randomized Clinical Trial

Objectives: To quantitatively evaluate soft tissue dimensional changes after immediate implant placement and provisionalization (IIPP) in the esthetic zone with or without connective tissue grafting (CTG). Methods: In this prospective clinical trial, 44 patients requiring a single maxillary anterior immediate implant were randomly allocated to a test group (IIPP + CTG) or a control group (IIPP alone). At baseline and 6 months postoperatively, buccal soft tissue height (STH) and soft tissue thickness (STT) at various levels were recorded. Measurements were obtained through three-dimensional superimposition of cone-beam computed tomography (CBCT) and intraoral scanning data. Results: Forty-three patients completed the 6-month follow-up. From baseline to 6 months, buccal soft tissue height increased 2.14 ± 0.74 mm and 1.71 ± 0.81 mm in the test and control groups, respectively, without statistically significant differences between groups (p = 0.078). Buccal soft tissue thickness increased at most measured levels in both groups (p < 0.05), except at 1 mm apical to the crest in the control group (p = 0.11). However, thickness augmentation was consistently greater in the test group at all levels (p < 0.001). Conclusions: Within the 6-month follow-up period, both soft tissue height and thickness increased after IIPP. CTG performed simultaneously with IIPP was associated with significantly thicker buccal soft tissue compared with IIPP alone.