The Use of Volume Stable Collagen Matrices (VCMXs) for Soft Tissue Augmentation Around Dental Implants: A Comprehensive Review

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Abstract
Adequate peri-implant hard and soft tissue volume is critical for ensuring implant stability, long-term functionality, and optimal esthetic results. While autogenous connective tissue grafts (CTGs) remain the gold standard for soft tissue augmentation, volume-stable collagen matrices (VCMXs) have emerged as a promising alternative, offering key advantages such as eliminating donor-site morbidity, reducing postoperative pain, and improving patient acceptance. This review summarizes the evidence on VCMXs from studies published between 1995 and 2024, with a focus on mucosal thickness gain, soft tissue stability, and patient-reported outcomes. To date, the evidence on VCMXs is still conflicting. Randomized controlled trials indicate that VCMXs can effectively increase peri-implant mucosal thickness (ranging from 0.3 to 1.0 mm), although the included clinical studies are very heterogeneous in terms of follow-up time. According to the literature, CTGs demonstrate superior long-term volumetric stability, particularly in highly esthetic zones. On the other hand, VCMXs demonstrated comparable mid-term outcomes while offering reduced postoperative discomfort, as confirmed by multicenter noninferiority trials. While VCMXs may yield slightly inferior clinical outcomes compared to CTGs, their patient-centered benefits make them a viable and often preferable option for soft tissue augmentation in implant dentistry. In conclusion, current evidence supports the use of VCMXs as valuable tools in contemporary implant therapy, particularly for specific indications where their benefits outweigh limitations.

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