Clinical efficacy of two vertical soft tissue augmentation techniques for peri‐implant crestal bone level stability: A randomized clinical trial.

Objectives: This study aimed to compare the efficacy of two techniques—acellular dermal matrix (ADM) grafting and tenting technique (TT)—for soft tissue height (STH) augmentation simultaneous to implant placement to minimize peri‐implant crestal bone level (CBL) changes. Methods: Forty patients with a healed single mandibular posterior edentulous site with a thin soft tissue phenotype were enrolled. Twenty patients received simultaneously to implant placement ADM grafting, while the others received submerged healing abutment (TT). Clinical peri‐implant soft tissue height and radiographic CBL changes were measured at restoration delivery and 1‐year follow‐up. Results: Both techniques effectively increased soft tissue thickness, resulting in a final average STH of 3.4 ± 0.5 mm after augmentation. On average, soft tissue increased by 1.6 ± 0.5 mm in group ADM and by 1.8 ± 0.4 mm in group TT after augmentation. In Group ADM, mesial CBL decreased from 0.4 ± 0.3 mm to 0.1 ± 0.2 mm, and distal CBL decreased from 0.5 ± 0.3 mm to 0.2 ± 0.3 mm over 1 year. In Group TT, mesial CBL remained stable at 0.3 ± 0.2 mm, while distal CBL reduced slightly from 0.5 ± 0.5 mm to 0.3 ± 0.2 mm. Both groups showed minimal changes in CBL, indicating great stability (pmesial = 0.003, pdistal = 0.004). TT was particularly effective in preventing mesial bone loss (pmesial = 0.019). The mesial CBL changes significantly differed between groups (p = 0.019), and not significantly at distal sites (p = 0.944). Neither treatment exhibited significant bone remodeling below the implant shoulder. Conclusion: This study suggests that both techniques were successful in STH augmentation, and they may effectively reduce peri‐implant crestal bone level changes, with TT being slightly superior. TT was more prone to post‐surgical complications. This RCT was not registered before participant recruitment and randomization. [ABSTRACT FROM AUTHOR]