Effect Of Free Gingival Graft Augmentation Procedures Around Mandibular Posterior Dental Implants Between First-stage And Second-stage Surgery

Objective: The objective of this study was to prospectively observe the efficacy of augmentation of keratinized tissue around dental implant with free gingival graft in the posterior tooth region between first-stage and second-stage surgery,and to evaluate the postoperative peri-implant health status,aesthetics,and patient subjective clinical evaluation.Methods: This study is a prospective case-series study.The participants of this study were the patients who received implantation in the posterior tooth area.And the width of keratinized tissue around implant was within 2 mm.Patients with PD no more than 5 mm,and PLI and BI less than 25%.After excluding contraindications,free gingival graft surgery was performed.Then,regular follow-up visits will be conducted in 1 weeks,2weeks,1 months,3 months and 6 months.The peri-implant soft tissue evaluation index,peri-implant clinical index and physician-patient clinical score were collected and statistically analyzed.The peri-implant soft tissue evaluation index included keratinized tissue width and thickness.The peri-implant clinical index included PD,BOP,PLI and GI.And physician-patient clinical score included MSI,postoperative hemorrhage,pain VAS and oedemata VAS.Results: In this study,15 patients and 28 implants were included.The keratinized tissues with width of 3.50±0.47 mm and thickness of 2.19±0.38 mm were obtained at six months after the surgery,and all the PD,PLI and GI were normal.None of patients suffered periimplant mucositis or peri-implantitis.The MSI was 1.07±0.66(1 month)and 0.52±0.64(3 months and 6 months).The VAS score of pain was 2.73±1.58 and the VAS score of oedemata was 1.13±0.74.Conclusion: Free gingival graft is efficient in augmentation of keratinized tissue around dental implant and could maintain the health condition of peri-implant.The aesthetic effects of FGG is satisfied and the pain and oedemata of patients is mild.But the followup period of this study is short and further research is needed to evaluate the long-term stability of free gingival graft in augmentation of keratinized tissue around dental implant.