Fascia lata allograft thickens peri-implant mucosa without a palatal harvest

The connective tissue graft (CTG) is the workhorse for thickening peri-implant mucosa, but it costs the patient a palatal donor site. Could a fascia lata allograft do the same job without that second wound? This prospective, randomized, examiner-blinded pilot trial enrolled 16 patients with a thin peri-implant phenotype needing single implants, allocated 1:1 to subepithelial connective tissue graft (SCTG) or fascia lata allograft (FLA), performed simultaneously with implant placement. The primary outcome was peri-implant mucosal thickness (PMT) by a stent-guided method; secondary outcomes were keratinized mucosal width (KMW), postoperative pain (VAS) and a wound-healing index, over 24 weeks.

Both grafts worked. PMT and KMW improved significantly over time in each group, and between-group differences were generally non-significant, except at one intermediate reference level, where SCTG had a slight edge at later visits. FLA showed lower postoperative pain at selected time points, the expected dividend of avoiding the palatal harvest, and healing was comparable.

The clinical relevance lies in avoiding donor-site morbidity. To augment peri-implant mucosal thickness around simultaneously placed implants, FLA emerges as a viable alternative to autogenous grafting, trading a slight localized thickness advantage for SCTG against a gentler postoperative course. The study is small and short, 16 patients over 24 weeks, and explicitly a pilot, so it establishes feasibility rather than equivalence. Larger, longer trials are needed before recommending FLA as a routine substitute, but for the clinician weighing patient morbidity against a marginal thickness gain, the signal is genuinely useful.