Purpose The aim of this study was to evaluate the effect of connective tissue grafts (CTG) and pediculated connective tissue grafts (P-CTG) for extraction socket closure on soft tissue landmarks and ridge dimensions.

Methods 45 subjects were randomized into two groups, where the soft tissue closure of extraction sockets was done by pediculated connective tissue grafts (P-CTG group) and connective tissue grafts (CTG group). On photographs taken at different time-points, four markers corresponding to marginal gingiva (MG), mucogingival junction (MGJ), mesial papilla (MP) and distal papilla (DP) were placed. After image alignment and stacking, the markers were tracked through five photographs taken during the course of the therapy. The displacement, total displacement (TD), divergence and angle of maximum divergence (AMD) for each marker were recorded. Buccolingual and mesiodistal dimensions of edentulous sites were measured, and the difference from the baseline to 6-months in both the dimensions was calculated and was described as buccolingual gain (BL gain) and mesiodistal gain (ML gain) respectively.

Results Intergroup comparison of displacement and divergence of markers across both the groups showed varying levels of significance. P-CTG resulted in higher buccolingual dimensions at 3 months (P=0.001) and 6 months (P=0.002) when compared to the CTG group. From baseline to 6-months, the BL and MD gains were 2.82±1.29mm & 1.68±1.12mm and 1.27±0.65mm & 1.48±0.67mm in P-CTG and CTG group respectively. In the P-CTG group, TD (r=0.4; P=0.001) & AMD (r=0.5; P=0.05) of MG and TD (r=0.2; P=0.005) of MGJ resulted in BL gains. In the CTG group, TD (r=0.7; P=0.004) and AMD (r=0.3; P=0.004) of MP and AMD of MGJ was associated with a significant BL gain.

Conclusions P-CTG and CTG had significant effects on displacement and divergence of soft tissue landmarks respectively. The relocation of these landmarks, seem to result in an improvement in the buccolingual dimensions of the post-extraction ridge.

The authors have declared no competing interest.

NCT05342649

This study did not receive any funding

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Approval from institution ethical committee SVS institute of Dental Sciences was obtained and informed consent was taken from all the subjects.

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable.

Yes

All data produced in the present work are contained in the manuscript