الفهرس 
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Abstract
Recently, human fascia Lata allograft (FLA) offers a new allogenicderived acellular matrix has been approved as a soft tissue graft substitute and possible alternative to SCTGs and ADM in periodontal plastic surgery. This study evaluated clinically and histologically the effect of FLA in terms of avoiding the morbidity of human donor tissue, its greater availability, low cost, and ability to be harvested in large quantities. Sixteen patients were accepted (8 control, 8 experimental) have accomplished the study to date and Sites were divided randomly into two groups (I and II), 8 sites in each group, each subject received one implant in the jaw. The first group (group I) consists of 8 sites received dental implants with autogenous SCTGs. While the second group (group II) involved 8 sites received dental implants with FLA. In our study the main primary aim was to evaluate peri-implant mucosal thickness (PMT) changes around a single tooth dental implant after following two different surgical protocols. Secondary aims were to evaluate changes in modified wound healing index (MWHI), keratinized mucosal width (KMW), patient-reported outcomes and visual analog score (VAS) was used for patients to rate their discomfort at the follow-up visits. After clinical outcomes the third aim was to evaluate FLA bio integration histologically and histomorphometrically compared to SCTGs at 3month of healing. Clinical results: Regarding wound healing the healing scores at all other time points were not statistically different between the control and experimental groups except graft exposure in three cases in both groups. All complications were resolved by the 8-week follow-up. VAS was not statistically significant between both groups at (1st, 6th hours and 1st day post-surgery), statistically significant 12h and at day 7(p-value = .001) and highly significant at day3) in favor of the test group, after 15 day it was not statistically significant between two groups. The KMW significantly increased in both methods (SCTGs &FLA) between the base line and 24 weeks post surgically. The gain of KMW was not statistically significantly different between groups (p=0.727). In general, there were no statistically significant correlations between PMT except for the change at 3mm apical to the CEJ in the control group only (p=0.048*). Histological results: Soft tissue biopsies (n=16) were harvested after three months during healing abutment connection through punch technique then the samples were evaluated histologically and histomorphometrically. Histological examination of soft tissue biopsies three months post-surgically revealed that both grafts were integrated well into the surrounding soft tissues, and they were almost completely biodegraded and organized by newly formed connective tissue. Immunohistochemical staining 3month post-surgically demonstrated positive expression in both groups. Statistical analysis of intensity of vimentin expression percentage was (24.95%) in FLA where it was 7.24% for SCTG group at 3 months post-surgically revealed significant difference in vimentin expression between two groups, significant increase in FLA graft in comparison with SCTGs graft. Regarding neo-angiogenesis, numerous blood vessels ingrowth was noticed, and all grafts appeared vascularized, the immunohistochemical expression of CD34, statistical analysis of Intensity of immune stain cd34 at 3 months post-surgically revealed significant difference in intensity of immune stain cd34 between two groups, significant increase in SCTGs graft in comparison with FLA graft. Based on this randomized clinical study we can advocate a significant advantage with the use of FLA for peri implant mucosal thicknesses enhancement around dental implant placed simultaneously compared to SCTGs especially in anterior esthetic maxilla.