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Free gingival graft in combination with apically positioned flap for establishment of keratinized gingiva around the implants: Report of two cases

J Korean Dent Assoc > Volume 54(4); 2016 > Article
The Journal of The Korean Dental Association 2016;54(4):296-305.
Published online April 30, 2016.
근단변위판막술과 함께 유리치은이식술을 사용하여 임플란트 주변 각화치은을 증대시킨 2건의 증례 보고
백원선1, 차재국2, 이재홍3, 이중석4, 정의원5
1연세대학교 치과대학 치주과학교실, 치주조직재생연구소
2연세대학교 치과대학 치주과학교실, 치주조직재생연구소
3연세대학교 치과대학 치주과학교실, 치주조직재생연구소
4연세대학교 치과대학 치주과학교실, 치주조직재생연구소
5연세대학교 치과대학 치주과학교실, 치주조직재생연구소
Free gingival graft in combination with apically positioned flap for establishment of keratinized gingiva around the implants: Report of two cases
Won-Sun Baek1, Jae Kook Cha2, Jae-Hong Lee3, Jung-Seok Lee4, Ui-Won Jung5
1Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University
2Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University
3Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University
4Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University
5Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University
Abstract
Narrow zone of attached gingiva and shallow vestibule around the implants might contribute to difficulty of cleasing, periimplant mucositis caused by incomplete cleansing and further peri-implantitis. The aim of this case report is to present modification of soft tissue biotype around the implants by free gingival grafts according to timing of surgical intervention and shape of free gingiva. A 44 year-old male patient had a missing area on lower right second molar area with 1 to 2 mm of narrow attached gingiva zone and wanted to be treated by implant placement. In radiographic analysis, there was enough alveolar bone to install an implant, free gingiva from hard palate was grafted following implant placement using double layer flap. The width of attached gingival was increased to 4 to 5mm and well maintained during 5 months of follow up. A 69 year-old female patient also had a missing area on lower right first and second molar area with 1 to 2 mm narrow attached gingiva. Since she had systematically angina pectoris and dental phobia, minimal invasive free gingival graft after implants placement was planned. After 2 months of implant surgery, free gingival graft surgery was performed with healing abutments connection. The grafted gingiva was composed of two strip shaped free gingiva, and they were immobilized by periodontal pack. The width of attached gingival was increased to 4 to 5mm and well maintained during 10 months of follow up. With prosthesis delivery, the patients recovered ideal periodontal environment around implants and masticatory function. In conclusion, periodontal health and masticatory function could be achieved through implant placement and free gingival graft.
Key Words: Dental implants;Free gingival graft;Keratinized gingiva augmentation;
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