A total of 15 patients were enrolled for the study, 12 females and 3 males, aged between 43 and 72 years old. Of these patients, 11 received surgery in the mandible and 4 in the maxilla. No complications were registered during surgeries and the immediate post-operative course was uneventful for all patients. At 1 year, 2 patients dropped out of the study: the first patient experienced a peri-implantitis that was solved with a conventional free gingival graft procedure while the second one developed peri-implant pockets with perimucositis, making the 1-year analysis possible only on 13 patients. No allergic reactions were registered during the clinical trial. The average keratinized tissue width before surgery was 0.4 mm. The initial gain in keratinized tissue (as measured immediately post-op) was 5.7 mm. Constant contraction of the grafted area, and decrease in keratinized tissue width, could be observed throughout 5 years of follow-up (Fig. 2). The initial 6 months were the most critical, with the highest reduction, resulting in a mean of 2.2 mm loss (37%) of value. Another 0.5 mm were lost in the following 6 months (leading to the 1 year examination time point), raising the value of contraction to 48%. After 1 year, the contraction considerably slowed down, with a further 11% width loss over the subsequent 4 years. The total loss after 5 years of follow-up was a mean value of 3.3 mm, corresponding to 59% of the initial measurement (Fig. 3). Clinically, it was assessed that the height of the keratinized tissue was, in any case, lower than the adjacent sites. Re-epithelization was excellent and complete in most patients after 4 weeks (Fig. 4). The matrix also proved to be a great hemostatic, with no bleeding referred by subjects in the post-op period. The procedure was short, with a mean operative time of 20 min from first incision to last suture, and painless, as referred by patients to the examiners during the first two follow-ups (Mankoski Pain Scale value of 1–2). No visible difference in texture and color could be found, after healing was complete, between the grafted area and surrounding tissue, ensuring a great esthetic outcome over the entire 5 years of follow-up.