Evaluation of the effects of ribose cross-linked thick collagen membranes with connective tissue grafts on soft tissue and post-operative patient comfort in areas with peri-implant soft tissue defects

Aim: In the treatment of soft tissue deficiencies, various methods have been used to increase the thickness of the peri-implant mucosa (PIMT) using materials that mimic biological tissues as well as grafts from the patient's own tissues. The aim of this study was to evaluate the effect of ribose cross-linked thick collagen membrane (RCCM) on PIMT in peri-implant areas with soft tissue deficiency in the horizontal direction and whether it can be an alternative method compared to subepithelial connective tissue graft (SCTG), which is considered the gold standard. Materials and Methods: Twenty systemically healthy patients were included in the study. Ten of the patients underwent SCTG simultaneously with the implant operation and the other 10 underwent RCCM. PIMT and peri-implant mucosa width (PIMW) measurements were performed before the operation. Visual Analog Scale (VAS) and Oral Health Impact Profile-14 (OHIP-14) scores were recorded on the 1st, 3rd and 7th postoperative days. PIMT and PIMW measurements were repeated at 1 and 3 months. Results: In terms of PIMT, an average increase of 1.87 mm was recorded in the RCCM group and 1.99 mm in the SCTG group. It was observed that the rates of increase in PIMT were similar in both groups. In terms of PIMW, the initial value of 3.35 mm in the RCCM group was measured as 3.30 mm at the end of the 3rd month. In the SCTG group, the value, which was 3.35 mm at the beginning, reached 4.70 mm at the end of the 3rd month. There was no statistically significant difference between the groups (p > 0.05). OHIP-14 scores were 17.5 on day 1 and 11.5 on day 7 in the RCCM group and 18.5 on day 1 and 15.1 on day 7 in the SCTG group. VAS scores were 5.09 on day 1 and 1.13 on day 7 in the RCCM group and 4.69 on day 1 and 2.5 on day 7 in the SCTG group. Conclusion: In line with the data of this study, it was determined that RCCM showed a similar effect to SCTG in terms of increasing PIMT during the 3-month follow-up period. However, longer follow-up periods are needed to evaluate RCCMM as a longterm alternative method to SCTG to increase PIMT. Keywords: Dental implant, Subepithelial connective tissue graft, Collagen membrane, Peri-implant mucosa thickness, Peri-implant mucosa width