**7. Conclusion**

PIS augmentation procedure has become an integral part of implant-prosthetic rehabilitation. The aim of PIS augmentation is adequate quality and quantity of PIS at least 2 mm of the width of peri-implant KM and 2 mm or more, of the thickness of PIS. These dimensions of PIS will result in stable peri-implant hard and soft tissue, better esthetical outcome and facilitate oral hygiene maintenance around the implant.

The use of autogenous soft tissue graft for PIS augmentation is considered the gold standard. FGG is primarily used for increasing the KM width and CTG for increasing the thickness of PIS. Different techniques have been developed for the harvesting of the CTG graft. The grafting technique and the choice of the donor site can influence different aspects of the procedure, from patient discomfort in the postoperative period to the quality and dimension of the graft. The choice of the grafting technique should be addressed individually based on the parameters of the specific clinical case (patient desire for decreased morbidity, anatomical limitations of the donor site, dimensions, and quality of the required graft).

The use of substitutional soft tissue grafts has different advantages—reduced length, the complexity of the procedure and patient morbidity, availability of the unlimited amount of the graft, and better patient acceptance. At the moment, the results of the use of substitutional grafts are inferior compared to soft tissue autografts. There is a lack of published long-term results of PIS augmentation with substitutional soft tissue grafts. Therefore, they should be used in cases where patient denial for soft tissue autografts would lead to rejection of the PIS augmentation procedure. In all other cases, priority should be given to soft tissue autografts.
