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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

J Korean Dent Assoc > Volume 55(1); 2017 > Article
The Journal of The Korean Dental Association 2017;55(1):30-41.
Published online January 31, 2017.
임플란트 주위 각화 조직 폭경의 증대를 위한 유리치은 이식술과 세포외 기질 이식술의 임상적 평가
정휘성1, 강준호2, 장윤영3, 윤정호4
1전북대학교 치의학전문대학원 치주과학교실, 구강생체과학연구소
2전북대학교 치의학전문대학원 치주과학교실, 구강생체과학연구소
3인하국제의료센터 치주과
4전북대학교 치의학전문대학원 치주과학교실, 구강생체과학연구소
Clinical evaluation of the effects of free gingival and extracellular matrix grafts to increase the width of the keratinized tissue around dental implants
Hwi-Seong Jeong1, Jun-Ho Kang2, Yun-Young Chang3, Jeong-Ho Yun4
1Department of Periodontology, School of Dentistry and Institute of Oral Bioscience, Chonbuk National University
2Department of Periodontology, School of Dentistry and Institute of Oral Bioscience, Chonbuk National University
3Division of Periodontology, Department of Dentistry, Inha International Medical Center
4Department of Periodontology, School of Dentistry and Institute of Oral Bioscience, Chonbuk National University
Abstract
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.
Key Words: Dental implants;Keratinized tissue;Free gingival graft;Extracellular matrix;
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