Clinical evaluations of free gingival grafting before implant placement to increase keratinized tissue width in molar regions: A retrospective case series.

Abstract

To evaluate the dimensional changes of the keratinized tissue width (KTW) in molar regions after augmentation by free gingival grafts (FGG) before implant placement. In seventeen patients, twenty implant sites in molar regions with KTW ≤3mm at the buccal aspect received FGG 2months before implant placement. KTW at the buccal aspect was measured before FGG (T0), immediately before implant placement (T1), at the time of impression taking for final prosthesis fabrication (T2), and at the end of the follow-up period after loading (T3, 12-48months). Changes in KTW before and after FGG, as well as the alterations during the follow-up period after loading, were analyzed. Shapiro-Wilk test, paired Student's t test, and Wilcoxon signed-rank test were used for the data analysis at α=0.05. KTW at the buccal aspect of the alveolar ridge was observed with a significant gain of 5.9±1.3mm at T1 (p<.001). The shrinkage of KTW from T2 to T3 was 8.5%, which was limited but statistically significant (p=.008). KTW at the buccal aspect of implant restorations was 5.0±1.5mm at T3. Within the limitations of the present study, our data suggest that using FGG to increase KTW in molar regions before implant placement had a predictable result. The buccal KTW had a limited reduction and was ≥3mm with more than 12months of follow-up after loading.