Danilo Fernandes

Objectives To evaluate buccal volume change after using a customized healing abutment with or without connective tissue grafts (CTG) in flapless maxillary immediate implant placement (IIP). Materials and Methods The present study was designed as a randomized clinical trial (RCT). Patients treated with flapless maxillary IIP were allocated into two groups, both receiving a customized healing abutment, and additionally, the test group received a CTG. A cone‐beam computerized tomography (CBCT) allowed to access the initial buccal bone thickness (BT). Digital impressions were taken prior to extractions (T0), 1 month (T1), 4 months (T2), and 12 months (T3) after implant insertion and superimposed with computer software allowing to compute variables related to buccal volume variation (BVv) and total volume variation (TVv) ( ClinicalTrials.gov : NCT05060055). Results Thirty‐two patients (mean age 48 ± 11 years), sixteen in each group, were evaluated after a 12‐month period. After 1 year of treatment, no significant differences were found between groups, although in participants with BT ≤1 mm, control and test groups showed a BVv of −14.18 ± 3.49% and −8.30 ± 3.78%, respectively ( p = .033). Regarding mucosa height variation variables, the control group showed approximately the triple vertical recession in both papillae. Conclusions The placement of a CTG was not capable of completely maintaining the initial peri‐implant tissue architecture, although in thin‐bone phenotypes, less dimensional changes are expected when a CTG was used.