Efficacy of a Modified Technique of Free Gingival Graft in Volumetric Changes of the Graft: Randomized Clinical Trial (EFFECT)

Efficacy of a Modified Technique of Free Gingival Graft in Volumetric Changes of the Graft: Randomized Clinical Trial

Efficacy of a Modified Technique of Free Gingival Graft in Volumetric Changes of the Graft: Randomized Clinical Trial

This study will compare a new technique of free gingival graft to the original one, in order to evaluate the stability of the graft volume over one year and other variables. Twenty patients will receive the original technique of free gingival graft (controls) and twenty patients will receive the modified technique, in which the free gingival graft is submerged (tests), at the inferior incisors area.

The free gingival graft surgery is held to gain some keratinized tissue in areas where it has been lost, such as in inferior incisors with gingival recessions. In these areas, tooth brushing may become harder and painful, negatively influencing in plaque control. However, this type of graft seems to contract over time. A new approach of free gingival graft, in which the graft is covered by a flap, promises to provide greater vascularization. This would promote less graft contraction and better mucosal color. Forty patients with less than 2 mm of keratinized tissue (measured from gingival margin to mucogingival junction) in at least one inferior incisor will be included. Half will receive the original technique and half will receive the modified one. Patients will be followed at 7, 14, 21, 28, 42 days, 3, 6 and 12 months after surgeries.

Twenty patients will receive the modified free gingival graft technique at the inferior incisors area. In this technique, the graft is covered by a flap, similarly to what is done in a connective tissue graft surgery.

Twenty patients will receive the original technique of free gingival graft at the inferior incisors area.

Surgical technique (autologous graft): Original technique of free gingival graft, positioned at the inferior incisors area at the donor area

Surgical technique (autologous graft): Free gingival graft. positioned at the inferior incisors area and covered by a flap at the donor area

Inclusion Criteria: Reduced keratinized tissue (less than 2 mm) in inferior incisors area Healthy periodontium in inferior incisors area Indication for surgery (e.g. pain during tooth brushing, gingival margin mobility, gingival recession...) Recessions class I, II or III, maximum 3 mm Having signed the informed consent Exclusion Criteria: Systemic diseases Smokers Pregnant and lactating women Root caries lesions Previous surgeries at same area Accentuated root abrasion Malpositioning teeth Residual pocket depths greater than 4 mm Tooth mobility greater than 1