The present study was undertaken to determine the predictability of using free gingival connective tissue grafts without epithelium in an attempt to increase the width of keratinized gingiva.
14 areas were chosen from 8 patients. 2.0 mm or less of width of keratinized gingiva, associated with pocketing of no more than 1.0 mm on the buccal aspect. age 27-55. measurements at 1, 2, 5, 10, 12 weeks. and at 6 months.
Split thickness flap by 2 vertical releasing incisions into the mucosa, at the buccal line angles of the teeth adjacent to the area to be treated were apically displaced but not sutured.
Donor Site:
Method 1 - a partial thickness flap is raised from the palatal and the connective tissue graft is taken from the palatal surface. The flap is then sutured back.
Method 2 - Graft material is obtained by thinning of a full thickness palatal flap. from the palatal.
Method 3 - A partial thickness flap is raised at the saddle area and graft material is taken from the underlying connective tissue.
Method 2 and 3 healed uneventfully, in all cases of the method 1 the primary flap degenerated to a varying degree.
The mean width of the graft being 5.54 mm with a range of 4.0-9.0 mm. At 6 months the mean width of keratinized gingiva was 4.58 mm with a range of 3.5-5.0 mm. Therefore at 6 months the mean contraction was 28% with a range of 0 to 50%.
The results show that an increase in attached gingiva can be achieved by grafting gingival connective tissue. This confirms that ultimate character is determined in the connective tissue.
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