Use of Mucograft Collagen Matrix® versus Free Gingival Graft to Augment Keratinized Tissue Around Teeth: A Randomized Controlled Clinical Trial

  • Amirreza Rokn Dental Implant Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
  • Hadi Zare Department of Periodontics, Faculty of Dentistry, Lorestan University of Medical Sciences, Khorramabad, Iran
  • Pardis Haddadi Mail Department of Periodontics, Faculty of Dentistry, Lorestan University of Medical Sciences, Khorramabad, Iran
Gingiva, Mucograft, Tissue Transplantation


Objectives: This study aimed to evaluate the mucograft collagen matrix (CM) to increase keratinized tissue around teeth compared to free gingival graft (FGG).
Materials and Methods: The present double-blind, randomized, controlled clinical trial studied 12 patients who had 2 mm or less keratinized gingiva bilaterally around mandibular premolars. The 6-month width of keratinized tissue, periodontal parameters (preoperatively and 1, 3, and 6 months postoperatively), color match, pain, and total surgical time were measured.
Results: The mean dimensional change of keratinized gingiva 6 months postoperatively was 4.1±0.7 mm for FGG and 8±1.7 mm for CM. Periodontal parameters were not affected in the two groups. The CM group had a significantly lower pain, experienced less surgery time, and gained better aesthetics compared to the FGG group.
Conclusion: CM appears to be a suitable substitute for FGG in procedures designed to increase keratinized tissue around teeth. It has remarkable benefits, such as acceptable keratinized tissue gain, less pain, less surgical chair time, and better aesthetics.


1. Shirmohammadi A, Faramarzie M, Lafzi A. A clinical evaluation of anatomic features of gingiva in dental students in tabriz, iran. J Dent Res Dent Clin Dent Prospects. 2008 Summer;2(3):90-4.
2. Lang NP, Löe H. The relationship between the width of keratinized gingiva and gingival health. J Periodontol. 1972 Oct;43(10):623-7.
3. Lindhe J, Nyman S. Alterations of the position of the marginal soft tissue following periodontal surgery. J Clin Periodontol. 1980 Dec;7(6):525-30.
4. Freedman AL, Salkin LM, Stein MD, Green K. A 10-year longitudinal study of untreated mucogingival defects. J Periodontol. 1992 Feb;63(2):71-2.
5. Chambrone L, Valenzuela FSG, Oliveira L. Rationale for Gingival Tissue Augmentation and Vestibuloplasty Around Teeth and Dental Implants. In: Nares S. Advances in Periodontal Surgery. A Clinical Guide to Techniques and Interdisciplinary Approaches. Springer Nature Switzerland AG, 2020:157-176.
6. Thoma DS, Benić GI, Zwahlen M, Hämmerle CH, Jung RE. A systematic review assessing soft tissue augmentation techniques. Clin Oral Implants Res. 2009 Sep;20 Suppl 4:146-65.
7. Edel A. The use of a free connective tissue graft to increase the width of attached gingiva. Oral Surg Oral Med Oral Pathol. 1975 Mar;39(3):341-6.
8. Nevins M, Nevins ML, Kim SW, Schupbach P, Kim DM. The use of mucograft collagen matrix to augment the zone of keratinized tissue around teeth: a pilot study. Int J Periodontics Restorative Dent. 2011 Jul-Aug;31(4):367-73.
9. McGuire MK, Scheyer ET. Randomized, controlled clinical trial to evaluate a xenogeneic collagen matrix as an alternative to free gingival grafting for oral soft tissue augmentation. J Periodontol. 2014 Oct;85(10):1333-41.
10. Dragan IF, Hotlzman LP, Karimbux NY, Morin RA, Bassir SH. Clinical Outcomes of Comparing Soft Tissue Alternatives to Free Gingival Graft: A Systematic Review and Meta-Analysis. J Evid Based Dent Pract. 2017 Dec;17(4):370-380.e3.
11. Menceva Z, Dimitrovski O, Popovska M, Spasovski S, Spirov V, Petrushevska G. Free Gingival Graft versus Mucograft: Histological Evaluation. Open Access Maced J Med Sci. 2018 Mar 27;6(4):675-679.
12. Schmitt CM, Moest T, Lutz R, Wehrhan F, Neukam FW, Schlegel KA. Long-term outcomes after vestibuloplasty with a porcine collagen matrix (Mucograft® ) versus the free gingival graft: a comparative prospective clinical trial. Clin Oral Implants Res. 2016 Nov;27(11):e125-e133.
13. Sanz M, Lorenzo R, Aranda JJ, Martin C, Orsini M. Clinical evaluation of a new collagen matrix (Mucograft prototype) to enhance the width of keratinized tissue in patients with fixed prosthetic restorations: a randomized prospective clinical trial. J Clin Periodontol. 2009 Oct;36(10):868-76.
14. Bjorn H. Free transplantation of gingiva propria. Swed Dent J. 1963;22:684-689.
15. Stetler KJ, Bissada NF. Significance of the width of keratinized gingiva on the periodontal status of teeth with submarginal restorations. J Periodontol. 1987 Oct;58(10):696-700.
16. Deo SD, Shetty SK, Kulloli A, Chavan R, Dholakia P, Ligade S, et al. Efficacy of free gingival graft in the treatment of Miller Class I and Class II localized gingival recessions: A systematic review. J Indian Soc Periodontol. 2019 Mar-Apr;23(2):93-99.
17. Keceli HG, Aylikci BU, Koseoglu S, Dolgun A. Evaluation of palatal donor site haemostasis and wound healing after free gingival graft surgery. J Clin Periodontol. 2015 Jun;42(6):582-9.
18. Shah R, Thomas R, Mehta DS. Recent modifications of free gingival graft: A case series. Contemp Clin Dent. 2015 Jul-Sep;6(3):425-7.
19. Boháč M, Danišovič Ľ, Koller J, Dragúňová J, Varga I. What happens to an acellular dermal matrix after implantation in the human body? A histological and electron microscopic study. Eur J Histochem. 2018 Jan 22;62(1):2873.
20. Wei PC, Laurell L, Geivelis M, Lingen MW, Maddalozzo D. Acellular dermal matrix allografts to achieve increased attached gingiva. Part 1. A clinical study. J Periodontol. 2000 Aug;71(8):1297-305.
21. Basegmez C, Karabuda ZC, Demirel K, Yalcin S. The comparison of acellular dermal matrix allografts with free gingival grafts in the augmentation of peri-implant attached mucosa: a randomised controlled trial. Eur J Oral Implantol. 2013 Summer;6(2):145-52.
22. Wei PC, Laurell L, Lingen MW, Geivelis M. Acellular dermal matrix allografts to achieve increased attached gingiva. Part 2. A histological comparative study. J Periodontol. 2002 Mar;73(3):257-65.
23. McGuire MK, Nunn ME. Evaluation of the safety and efficacy of periodontal applications of a living tissue-engineered human fibroblast-derived dermal substitute. I. Comparison to the gingival autograft: a randomized controlled pilot study. J Periodontol. 2005 Jun;76(6):867-80.
24. McGuire MK, Scheyer ET, Nevins ML, Neiva R, Cochran DL, Mellonig JT, et al. Living cellular construct for increasing the width of keratinized gingiva: results from a randomized, within-patient, controlled trial. J Periodontol. 2011 Oct;82(10):1414-23.
25. McGuire MK, Scheyer ET. Long-Term Results Comparing Xenogeneic Collagen Matrix and Autogenous Connective Tissue Grafts With Coronally Advanced Flaps for Treatment of Dehiscence-Type Recession Defects. J Periodontol. 2016 Mar;87(3):221-7.
26. Wennström J, Lindhe J, Nyman S. Role of keratinized gingiva for gingival health. Clinical and histologic study of normal and regenerated gingival tissue in dogs. J Clin Periodontol. 1981 Aug;8(4):311-28.
How to Cite
Rokn A, Zare H, Haddadi P. Use of Mucograft Collagen Matrix® versus Free Gingival Graft to Augment Keratinized Tissue Around Teeth: A Randomized Controlled Clinical Trial. Front Dent. 17(1):e5.
Original Article