Use of a Collagen Matrix as a Substitute for Free Mucosal Grafts in Pre-Prosthetic Surgery: 1 Year Results From a Clinical Prospective Study on 15 Patients

Carlo Maiorana1, *, Mario Beretta1, Luca Pivetti1, Enrico Stoffella1, Giovanni B. Grossi1, Alan S. Herford2
1 Oral Surgery and Implantology Dental Clinic, Fondazione IRCCS Policlinico Ca'Granda, Via Francesco Sforza, Milano, Italy
2 Department of Oral & Maxillofacial Surgery, Loma Linda University, California, USA

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© Maiorana et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution-Non-Commercial 4.0 International Public License (CC BY-NC 4.0) (, which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Department of Fondazione IRCCS Policlinico Ca'Granda, Via della Commenda 10, 20122 Milan, Italy; Tel: 00390255032303; Fax: 0039028051204; E-mail:



The presence of keratinized tissue around dental implants is more than desirable either from a functional and aesthetic point of view, making soft tissue grafting a common practice in implant rehabilitation. Autogenous soft tissue grafting procedures are usually associated with high morbidity. Aim of this study was to assess the efficacy of a xenogeneic collagen matrix as a substitute for soft tissue grafting around dental implants.


15 consecutive patients underwent a vestibuloplasty and grafting, both in the mandible and the maxilla, with a collagen matrix.


The primary endpoint was to evaluate the resorption of the graft along with the re-epithelization grafted area. The percentage of the resorption was 44,4%, with a mean gain in vestibular height of 3 mm. Secondary endpoints evaluated the clinical appearance, the hemostatic effect and the post-operative pain. All subjects referred minimal pain with no bleeding. No adverse reaction nor infection were noted.


This study showed that the used collagen matrix can find major interest in those patients who need a greater aesthetic outcome as the matrix has a perfect integration with the surrounding tissues. Furthermore it is strongly recommended for those patients who can bear little pain.

Clinical Significance:

Post-operative morbidity of autologous grafts is the biggest concern of this type of surgery. The possibility to use a soft tissue substitute is a great achievement as morbidity decreases and bigger areas can be treated in a single surgery.

The present study showed the efficacy of a collagen matrix as this kind of substitute.

Keywords: Collagen matrix, Keratinized tissue, Mucosal grafts, Vestibuloplasty, Xenogeneic graft.