Dorfman, H, Kennedy, J, Bird, W. Longitudinal evaluation of free autogenous gingival grafts. A four year report. J. Perio. 53:349, 1982

This report does not support the hypothesis that a lack of attached gingiva, of and by itself, is detrimental to the periodontium provided inflammation is controlled.

This is an on-going 4-year study to determine the necessity for and effectiveness of the free autogenous gingival graft in maintaining periodontal attachment. The data was presented for 42 of initial 107 patient who had bilateral facial surfaces with inadequate attached keratinized gingiva including 22 patients who began with bilateral areas of recession and no attached gingiva. In both populations a free gingival graft was placed on one side and the contralateral side was treated by Sc/Rp to serve as the control. Patients were recalled at 3 to 6 months intervals.

2 patients removed from the study because of increased recession. One of these had inflammation (GI of 64%)

Results

• Plaque and gingival indices significantly decreased over 4 years on both the experimental and control sides.
• The experimental side had a decrease in recession of approximately 0.5 mm as well as a similar gain in attachment.
• The comparison of the 42 experimental and controlled gingival units after the 4-year evaluation period showed no significant differences between the two, groups for any gingival dimensions or indices except the greater quantity of keratinized and attached gingiva on the experimental side.
• Patients with Recession and No Attached Gingiva - after 4-years, a comparison of control and experimental sides showed significant differences in the quantity of keratinized and attached gingiva and recession. No other differences were observed.
• Most changes occurred at the 1 year point with no additional changes occurring over the next three years.

The report extends from the previous report, that areas w/ minimal attached gingiva or no attached gingiva will not further attachment loss if inflammation is controlled. creeping attachment was observed with the reduction in marginal tissue recession and the gain in attachment observed. The study does involve factors as restorative, fremulum or orthodontic movement.

The gingival graft procedure has proven to be beneficial, especially in areas where recession and no attached gingiva exists, however, control of inflammation appears equally effective in maintaining clinical attachment levels w/o the necessity for surgical intervention.

Back: Soft Tissue Articles
Menu: Literature Review Topics
Home: PIC Homepage