This review aims to evaluate the effectiveness of a collagen matrix (CM) utilized in periodontal plastic surgeries around natural teeth and implants. This review was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Review Manager 5.3 software was used for data analysis. Subgroup analyses were conducted by defect categories and follow-up periods. The GRADE system was applied to classify the quality of evidences. Out of 3,652 articles in the literature, 14 studies were included, totaling 1,260 defects in 565 participants. The meta-analysis showed that CM is superior to coronally advanced flaps (CAF) regarding gains in mean root coverage (MRC) and width of keratinized tissue (KTW). Insufficient evidence demonstrated that CM had higher complete root coverage (CRC). Connective tissue graft (CTG) presented better results in CRC, MRC, and KTW. Greater KTW was also found favoring CTG in implants. In subgroup analysis, moderate evidence showed that, compared to CTGs, CMs present similar results in CRC, MRC, and KTW when treating single gingival recessions. CTGs showed greater efficiency in KTW of multiple gingival recessions and long-term observations. CM presents suitable capabilities as an alternative to soft tissue graft, while CTG still shows better results in most clinical parameters.