Star Matrix vs Autogenous Graft for Gingival Augmentation: Split-Mouth RCT

Inclusion Criteria: * Adults 20 - 80 years old who need gingival augmentation on both sides of the lower jaw. * Able and willing to sign the consent form, follow study instructions and return for all visits * Generally healthy (no significant illnesses or medicines that could interfere with healing). * Demonstrates good daily oral hygiene (low plaque levels at baseline). Exclusion Criteria: * Does not meet any of the inclusion points or is unlikely to follow the schedule * Previous gingival graft at the study site that failed * Needs a root-coverage (recession-repair) procedure instead of simple width augmentation * Active, untreated gum disease, cavities, infection, or chronic inflammation near the study teeth * Used cigarettes, e-cigarettes, or other nicotine products within 3 weeks * Insulin-dependent diabetes or hemoglobin A1c \> 6.5 % * Cancer (other than minor skin cancers or in-situ cervical cancer) within the past 5 years * Currently pregnant or breastfeeding * Taking (or soon to begin) drugs that change bone turnover (e.g., bisphosphonates, steroids) * Diseases that disturb bone metabolism (except common osteoporosis) * Auto-immune disease or known allergy to porcine collagen or study materials * Active infection at the planned graft site * Current use of systemic blood thinners (anticoagulants or antiplatelet agents; e.g., warfarin, heparin/LMWH, DOACs such as apixaban/rivaroxaban/dabigatran/edoxaban, or P2Y12 inhibitors such as clopidogrel/prasugrel/ticagrelor)