• Title/Summary/Keyword: Free gingival graft

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Free gingival graft for the increase of peri-implant attached keratinized mucosa decreased after guided bone regeneration (골 유도 재생술 후 감소된 임플란트 주위 부착 각화 점막 증대를 위한 유리 치은 이식술 증례)

  • Kim, Deug-Han;Ji, Suk;Pang, Eun-Kyoung
    • Journal of Periodontal and Implant Science
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    • v.38 no.4
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    • pp.723-728
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    • 2008
  • Purpose: During guided bone regeneration procedures for the augmentation of deficient alveolar ridge, primary closure of flap is necessary. For primary flap closure, flap is repositioned coronally and the zone of attached keratinized mucosa may decreased. The need for attached keratinized mucosa around dental implants is still controversial, but sufficient peri-implant attached keratinized mucosa would be beneficial for functional and esthetic aspects. This case report presents three cases that demonstrated free gingival graft for increasing the zone of peri-implant attached keratinized mucosa which was decreased after guided bone regeneration. Materials and Methods: In first case, maxillary incisors were extracted and guided bone regeneration was performed simultaneously. Because the membrane was exposed at 3 weeks after operation, the membrane was removed and free gingival graft was performed for primary flap closure. Free gingival graft was performed again at implant placement for the increase of attached keratinized mucosa. In second case, guided bone regeneration was performed on lower right first molar area, and implant was placed with free gingival graft. In third case, lower right molar area showed insufficient attached keratinized mucosa after implant placement with guided bone regeneration. When abutments were connected, free gingival graft with apically positioned flap was performed. Result: In these three cases, the zone of attached keratinized mucosa around dental implants was decreased after guided bone regeneration. And the increase of peri-implant attached keratinized mucosa could be obtained effectively by free gingival graft. Conclusion: Free gingival graft could be a effective treatment method increasing the zone of attached keratinized mucosa which was decreased after guided bone regeneration procedures.

The Clinical Study on ShrinKage Rate of Graft following Strip Gingival Autografts (Strip 치은자가이식술후 이식편의 수축률에 관한 임상적 연구)

  • Jung, Hae-Su;Lim, Sung-Bin;Chung, Chin-Hyung
    • Journal of Periodontal and Implant Science
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    • v.27 no.3
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    • pp.549-559
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    • 1997
  • The purpose of this study was to evaluate clinical changes in graft size after treatment with strip gingival autograft in human. 57 premolar teeth in 27 patients having the following mucogingival problems were selected. The width of extension, attached gingiva including free marginal gingiva, width of transplant and clinical sulcus depth were measured at the initial examination, 2, 12 and 24 weeks following the strip gingival autograft and free gingival autograft. The change of width of extension, attached gingiva including free marginal gingiva, width of transplant and clinical sulcus depth according to healing process in both graft procedures was statistically analyzed by repeated measure ANOVA test and independent t-test using SPSS program. The results were as follows : 1. The change of keratinized gingiva in both graft procedures was increased significantly at 24 weeks post-op. 2. The clinical sulcus depth exhibited no marked changes throughout the entire investigation in both graft procedures. 3. No dimensional variation was seen in graft size in both graft procedures. 4. Shrinkage did not differ significantly in both graft procedures. From the day of grafting to 24 weeks after surgery the percentages of shrinkage were : strip gingival autograft 28% and free gingival autograft 29%.

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Free gingival graft for treatment of gingival recession relapsed after laterally positioned flap surgery: a case report (측방변위판막술 후 재발된 하악 전치부 순면 치은퇴축의 유리치은이식술을 이용한 치근 피개: 증례보고)

  • Joo, Myung-Jae;Cha, Jae-Kook;Lee, Jung-Seok;Jung, Ui-Won
    • The Journal of the Korean dental association
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    • v.55 no.7
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    • pp.450-456
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    • 2017
  • The purpose of this case report is to present a case of free gingival graft for treatment of mandibular incisor labial gingival recession relapsed after laterally positioned flap surgery. A 22 year-old female patient with discomfort and labial gingival recession on left mandibular central incisor was treated. The patient had been treated root coverage on same site by laterally positioned flap surgery, but treated site had relapsed in one month. Exposed root surface was covered by free gingiva from left palatal area. Although gingival color did not completely match with adjacent gingiva, more than 5mm keratinized gingiva was attained. The patient showed no further recurring pain and recession on gingiva after 5 months from the surgery. In conclusion, the root coverage with gain of keratinized gingiva could be achieved through free gingival graft from palate on relapsed gingival recession.

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A modified free gingival graft technique for the treatment of oro-antral sinus track: A case report (변형된 유리치은 이식술을 이용한 구강-상악동 농루의 치험례)

  • Park, Se-Ho;Han, Ji-Young
    • Journal of Periodontal and Implant Science
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    • v.38 no.1
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    • pp.109-113
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    • 2008
  • Purpose: Surgical intervention into the maxillary posterior area can lead to inadvertent communication with the maxillary sinus. Spontaneous healing of 1 to 2 mm openings can occur. However, in patients with larger oro-antral communications and those with a history of sinus disease, surgical closure is often indicated. Materials and Methods: In this case, a modified free gingival graft technique was used. The oro-antral sinus track after extraction was about $2{\times}4\;mm$. But the patient had a history of Caldwell-Luc operation. Immediately after extraction, a modified free gingival graft was used for the closure of oro-antral sinus track. Result: A modified free gingival graft technique was successfully used for the closure of oro-antral sinus track. With this technique, esthetic results including similar colors, textures were achieved. Conclusion: It is thought that this technique is very useful in the closure of oro-antral sinus track.

Histological healing after grafting of bilayer artificial dermis in the oral environment (치은부에 이식한 이중인공진피의 조직학적 치유)

  • Kim, Min-Jeong;Chung, Hyun-Ju;Kim, Ok-Su;Kim, Young-Joon
    • Journal of Periodontal and Implant Science
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    • v.33 no.2
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    • pp.289-299
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    • 2003
  • The autogenous free gingival graft is the most predictable procedure currently used to increase the width of the attached gingiva in periodontics. But the major disadvantage of the procedure is to create the multiple surgical wounds at both a donor site and a recipient site. The other problem is the limited amount of available graft material in oral cavity. Therefore, recent researches have been focused to develop the biomaterial to substitute the autogenous gingival tissue. The purpose of this study was to evaluate the histologic healing after grafting of bilayer artificial dermis, compared to the free gingival graft. Four non-smoking subjects (mean age, 32.5 years) in systemically healthy state and good oral hygiene were selected according to their particular needs for correction of mucogingival problems as suggested by Nabers(1966). The recipient sites were prepared through the procedure for the free gingival graft and were grouped according to the graft materials: Experimental group(n=5) - bilayer artifcia1 dermis ($Terudermis^{(R)}$; Terumo Co. Japan) and Control group(n=6) - free gingival graft with autogenous palatal mucosa. Biopsies were harvested at 1,2,3 and 6 weeks postsurgery to evaluate histologically. At the third week in the experimental group and at the second week of in the control group, the grafts has been clinically stabilized on the recipient bed and the graft border has been blended into the surrounding tissue. In the experimental group after 1 week of grafting, the epithelial migration from the adjacent tissue to graft material was seen and after 3 weeks of grafting, the : nflmmation decreased, collagen layer of the artificial dermis was lost and the basement membrane of epithelium was formed. After 6 weeks of grafting, both groups demonstrated orthokeratinized epithelium and increased thickness of epithelial tissue and the rete peg formation, similar to the adjacent tissue, Histologic evaluation revealed a biologic acceptance and incorporation of the collagen layers of the graft tissue to the host tissue, without foreign body reaction. In conclusion, a bilayer artificial dermis is essentially similar to autogeneous free gingival graft in the correction of mucogingival problems, and has the advantages of decreased patient morbidity (no donor site) and availability of abundant amounts of graft material when needed.

Retrospective case series analysis of vestibuloplasty with free gingival graft and titanium mesh around dental implant

  • Ku, Jeong-Kui;Leem, Dae Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.46 no.6
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    • pp.417-421
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    • 2020
  • Objectives: The purpose of this paper is to introduce an effective technique to easily obtain adequate amounts of keratinized gingiva and vestibular depth. Materials and Methods: Free gingiva (vertical height 10 mm) was harvested on the palatal mucosa and a partial thickness flap was elevated on the recipient site with same width as the free gingiva graft. After a conventional suture, a titanium mesh covered the graft and was fixed with miniscrews. Titanium mesh was removed 4.1±2.5 weeks after surgery. The amount of keratinized gingiva and vestibular depth was measured at the final follow-up. Results: Nine patients (males 4, females 5; 53.9±14.1 years) who underwent bone graft surgery before vestibuloplasty were included. No free gingival graft failure or complications were encountered in any of the patients. The relapse rate for vestibular depth (23.3%) was lower than that for keratinized gingiva (48.3%) after 34.4±14.4 months (P=0.010). Conclusion: Vestibuloplasty with a free gingival graft using titanium mesh could be achieved with an acceptable amount of keratinized gingiva and an appropriate vestibular depth around dental implant.

The effect on the formation of keratinized attached gingiva using free gingival graft with strip technique (Strip 형 유리치은 이식술이 부착지은 형성에 미치는 영향)

  • Lee, Dong-Yeol;Kwon, Young-Hyuk;Park, Joon-Bong;Herr, Yeek;Chung, Jong-Hyuk
    • Journal of Periodontal and Implant Science
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    • v.36 no.2
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    • pp.305-318
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    • 2006
  • This study was performed to evaluate the effect on the formation of keratinized attached gingiva when free gingival graft with strip technique was used. After the partial thickness flap was prepared, it was positioned apically more than 7mm using mucoperiosteal suture. At the donor site, strip was achieved with 2mm width, less than 1mm thickness, (mesiodistal teeth length + 6)$^{\ast}$2 mm length. Then, it was divided into 2 same pieces and located at the recipient bed apico-coronally with more or less 3mm interval. Follow-up check was made at 1,2,4,8,12 weeks after the operation. The results of this study were as follows : 1. The inter-strip space was mostly filled with keratinized attached gingiva. 2. The contraction of the graft was nigligible, and 92% of planned area was filled with keratinized attached gingiva. 3. The inconvenience of the patients at donor site was minimal. 4. The width of the strip was widened. In conclusion, free gingival graft using strip technique is useful to achieve the keratinized attached gingiva maximally with free gingival graft minimally and to minimize the inconvenience of donor palatal site of the patients.