• Title/Summary/Keyword: Free gingival graft

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Clinical evaluation of the effects of free gingival and extracellular matrix grafts to increase the width of the keratinized tissue around dental implants (임플란트 주위 각화 조직 폭경의 증대를 위한 유리치은 이식술과 세포외 기질 이식술의 임상적 평가)

  • Jeong, Hwi-Seong;Kang, Jun-Ho;Chang, Yun-Young;Yun, Jeong-Ho
    • The Journal of the Korean dental association
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    • v.55 no.1
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    • pp.30-41
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    • 2017
  • Inadequate keratinized mucosa around dental implants can lead to more plaque accumulation, tissue inflammation, marginal recession and attachment loss. We evaluated the effects of free gingival and extracellular matrix membrane grafts performed to increase the insufficient width of keratinized tissue around dental implants in the posterior mandible. A 47-year-old female patient presented with discomfort due to swelling of the lower right second premolar area. Due to severe destruction of alveolar bone, the tooth was extracted. After 3 months, a guided bone regeneration (GBR) procedure was performed and then a dental implant was placed 6 months later. During the second-stage implant surgery, free gingival grafting was performed to increase the width of the keratinized tissue. After 12 months, a clinical evaluation was performed. A 64-year-old female patient had a missing tooth area of bilateral lower molar region with narrow zone of keratinized gingiva and horizontal alveolar bone loss. Simultaneous implant placement and GBR were performed. Five months after the first-stage implant surgery, a gingival augmentation procedure was performed with an extracellular matrix membrane graft to improve the width of the keratinized tissue in the second-stage implant surgery. After 12 months, a clinical evaluation was performed. In these two clinical cases, 12 months of follow-up, revealed that the increased width of the keratinized tissue and the deepened oral vestibule was well maintained. A patient showed a good oral hygiene status. In conclusion, increased width of keratinized tissue around dental implants could improve oral hygiene and could have positive effects on the long-term stability and survival rate of dental implants. When planning a keratinized tissue augmentation procedure, clinicians should consider patient-reported outcomes.

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Vestibuloplasty covering titanium mesh with grafted free gingiva on anterior mandible: technical report and rationale

  • Ku, Jeong-Kui;Leem, Dae Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.45 no.6
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    • pp.369-373
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    • 2019
  • This paper describes a patient with an insufficient vestibular depth for a removable partial denture who underwent vestibuloplasty with a free gingival graft using a titanium mesh in the anterior mandible. Free gingiva was harvested from the palatal mucosa, and a partial thickness flap was elevated at the recipient site. After minimal suturing for the graft, a titanium mesh was fixed over the graft. The mesh was removed four weeks after surgery. The patient obtained an adequate vestibular depth and keratinized gingiva eight weeks after surgery without any complications. In this case, an appropriate vestibular depth and keratinized gingiva were easily obtained by vestibuloplasty using a titanium mesh.

Socket Preservation Utilizing Modified Free Connective Tissue Graft for Primary Closure : Wing Graft (발치와 보전술식시 변형 유리 결체조직 이식술을 이용한 일차 페쇄술식 : 익이식술)

  • Min, Kyoung-Man;Han, Soo-Boo;Lee, Chul-Woo;Kim, Dong-Kyun;Leem, Sang-Hoon
    • Journal of Periodontal and Implant Science
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    • v.28 no.3
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    • pp.409-418
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    • 1998
  • The socket preservation technique is very effective in preventing alveolar ridge collapse after tooth extraction. Many technigues have been proposed for the primary closure of the flap and we tested a new graft design, "wing graft", which is a modification of free connective tissue graft in this case report. With this technique, primary closure was achieved without shallowing the vestibule. Additionally some vertical ridge augmentation effect could be observed and therefore good esthetic and functional results were obtained from this technique even in the case where severe bone loss and gingival recession was present. Finally we observed good healing appearance in the donor site after 2weeks. The results from this report suggest that this "wing graft" can be used successfully as an adjunctive procedure with socket preservation technique.

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TREATMENT OF HEAVY BUCCAL FRENUM USING FRENOTOMY AND AUTOGENOUS FREE GINGIVAL GRAFT IN CHILDREN : A CASE REPORT (소아에서 소대절개술 및 자가유리치은이식술을 이용한 거대협소대의 치료증례)

  • Kweon, Hoon;Choi, Yong-Seong;Lee, Sang-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.21 no.2
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    • pp.533-539
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    • 1994
  • The mandibular buccal frenum is a fold of mucous membrane at the posterior labial vestibule, that attaches the lips and the cheeks to the alveolar mucosa, gingiva, and underlying periosteum. The buccal frenum becomes a problem if its attachment is too close to the marginal gingiva. It may then pull on healthy gingiva, encourge plaque formation and interfere with tooth brushing. Heavy buccal frenum mucogingivally results in insufficient attached gingiva, inadequate vestibular depth and high frenum attachment and also difficulty in eruption of mandibular second premolar. Frenectomy in various forms has been used for many years to remove the influence of the frenum. Unfortunately, the results are not always ideal and there is often postoperative relapse because of muscle pull. In this treatment, frenotomy was used in conjuction with autogenous free gingival graft with the object of removing the influence of the buccal frenum and creating an adequate and stable width of attached gingiva. We observed decrease in muscle pull, adequate width of attached gingiva and increased vestibular depth in addition to progressive eruption of second premolar. Periodic follow-up is needed for evaluation of relapse, grafting gingiva and also space regaining for second premolar.

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A retrospective comparison of 3 approaches of vestibuloplasty around mandibular molar implants: apically positioned flap versus free gingival graft versus modified periosteal fenestration

  • Lee, Won-Pyo;Lee, Kyoung-Hoon;Yu, Sang-Joun;Kim, Byung-Ock
    • Journal of Periodontal and Implant Science
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    • v.51 no.5
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    • pp.364-372
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    • 2021
  • Purpose: This study aimed to clinically evaluate the efficacy of vestibuloplasty around lower molar implants using 3 different modalities: apically positioned flap alone (APF), APF with a free gingival graft (FGG), and APF with modified periosteal fenestration (mPF). Methods: Three different vestibuloplasty procedures during second-stage implant surgery were performed at the mandibular molar area in 61 patients with a shallow vestibule and insufficient keratinized tissue (KT). The clinical measurements of KT width were recorded at baseline, immediately after surgery (T0), 6 months after surgery (T6), and 12 months after surgery (T12). Soft tissue esthetic scores were measured. Results: An additional KT width gain from baseline to T12 of approximately 2 mm was obtained with FGG and mPF compared to that with APF. Shrinkage of the re-established tissue was lower with mPF and FGG than with APF, whereas the esthetic profile was better with APF and mPF than with FGG. Conclusions: Within the limitations of this study, mPF showed potential as a promising approach for vestibuloplasty around the lower molar implants compared to the traditional APF and FGG.

Root coverage with subeptithelial connective tissue grafts (상피하결합조직 이식술을 이용한 치근면 피개)

  • Song, Hyun-Jong;Jang, Hyun-Seon;Kim, Byung-Ock
    • Journal of Periodontal and Implant Science
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    • v.37 no.3
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    • pp.625-636
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    • 2007
  • Marginal tissue recession makes problems like esthetics, root caries, hypersensitivity and plaque accumulation. Request for root coverage is higer than ever, especially esthetic problems involved. So techniques for root coverage hav been developed. There are some kinds of surgical techniques using soft tissue for root coverage. For example, free gingival graft, kinds of pedicle flap, subepithelial connective tissue graft(SCTG), and so on. Subepithelial connective tissue graft has many advantage for root coverage, that is less pain on donor site, good blood supply for graft, and more esthetic result. For this reaseon, this case report was performed to evaluate the effect of root coverage using subepithelial connective tissue graft. Three patients has Miller's class I marginal tissue recession and one patients has Miller's class III marginal tissue recession. The following period is 36.5 month on average. The results are as follows: 1. Root coverage of 100% was obtained in 5 of 6 defects, and 80% was obtained in 1 of 6 defects, The mean root coverage was 96,6% in six cases on 4 patients. 2. The mean root coverage was 3.83mm and mean recession depth decreased from 4mm to 0.16mm. 3. The mean width of clinical attached gingiva increased from 1.5mm to 4mm. The mean width of gained attached gingiva after surgery was 2.5mm. 4. The mean follow up period was 36.5 months. The longest follow up period was 50 months and the shortest follow up period was 22 months. 5. The result that obtained by surgery was stable during follow up period. Within the above results, root coverage with SCTG is an effective procedure to cover marginal tissue recession defect with long term stability.