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Case Reports
. 2019 Jan-Feb;23(1):77-80.
doi: 10.4103/jisp.jisp_156_18.

A modified free gingival graft technique for gaining vertical and horizontal soft tissue augmentation

Marcelo Hissao Imano  1 , Emanuelle Juliana Cunha  2 , Carmen Lúcia Mueller Storrer  2 , Tatiana Miranda Deliberador  2
Affiliations
Case Reports

A modified free gingival graft technique for gaining vertical and horizontal soft tissue augmentation

Marcelo Hissao Imano et al. J Indian Soc Periodontol. 2019 Jan-Feb.

Abstract

The aim of this case report was to describe a modified free gingival graft technique for gaining vertical and horizontal soft-tissue growth in the posterior region of the mandible before installation of dental implants. Patient A.A., a 38-year-old female, received a modified free gingival graft in the posterior region of the mandible. After 90 days, an increase, both horizontally and vertically, of the gingival tissue was observed, and the patient was satisfied with the result. The dental implant was installed, and a 3-mm of the vertical gain of keratinized gingiva was observed. Further research is needed to evaluate the effectiveness of this technique before prosthetic dental implantation.

Keywords: Grafts; implants; keratinized mucosa; soft tissue.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
(a) Vestibular and (b) occlusal view showing the small amount of keratinized gingiva
Figure 2
Figure 2
Horizontal incision below the mucogingival line and the bony crest
Figure 3
Figure 3
Vertical incision made in the mesial
Figure 4
Figure 4
Vertical incision was made in the distal
Figure 5
Figure 5
Papilla of teeth 33 and 36 preserved
Figure 6
Figure 6
A partial thickness flap was performed in the buccal region of the mandible
Figure 7
Figure 7
Harvesting graft from the palate
Figure 8
Figure 8
Removal of the epithelium tissue from part of the free gingival graft with the aid of a 15C scalpel blade
Figure 9
Figure 9
(a) Suture starting in the lingual mucosa, passing through the de- 9:epithelized graft and returning to the lingual mucosa, the graft is tractioned by the suture under the mucosa of the osseous ridge; (b) part of the epithelized graft covers the partial thickness flap on buccal side
Figure 10
Figure 10
(a) A compression suture and (b) two simple mesial and distal sutures were made for the graft stabilization
Figure 11
Figure 11
Occlusal view of the keratinized gingiva thickness (a) before the surgical procedure and (b) after 90 days
Figure 12
Figure 12
After 90 days, a vertical increase of the gingiva was observed after implant installation
Figure 13
Figure 13
Thickness and height of the keratinized tissue remained unchanged after installed healing cap
See this image and copyright information in PMC

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