Gingival Augmentation Around Implants During Maintenance

Objectives: The purpose of this study was to evaluate biological and esthetic outcomes following free gingival grafts (FGGs) around dental implants.
Methods: IRB approval was obtained to conduct the study in dental clinics at University of Maryland School of Dentistry. Four males and 11 females were enrolled based on the following inclusion criteria: 1) single-unit-osseointegrated implant having opposing teeth/prostheses, 2) the restoration has been in service for a minimum of 6 months, 3) less than 2mm keratinized gingiva (KG) around the implant, and 4) age >18 years old. Diabetes mellitus patients and smokers were excluded. The subjects were randomly assigned either to the experimental or to the control group. FGG was performed on the buccal surfaces of implant(s) in the experimental group. Only oral prophylaxis was performed in the control group. The following data were obtained: gingival recession (GR), probing depth (PD), the width of KG, plaque index (PI), and gingival index (GI) at baseline and at 12-month-maintenance. Clinical measurements were compared using a two-way analysis of variance followed by a post hoc test and a Mann-Whitney U Test. A p<0.05 was considered significant.
Results: Mean ages of subjects were 64 and 60 years old in the experimental and the control group respectively. Twenty-four implants from 15 subjects were examined. There were no significant differences in GR, PD, KG, and GI between two groups at baseline (p>0.05). Mean KG gain in the experimental group was 3.4±0.2mm with no significant difference in the control group. The mean Pl and GI were significantly lower for the experimental group (p<0.05) at 12-month-maintenance compared to those for the control group.
Conclusions: FGG is an effective method to create and/or increase KG. Augmented KG around implants was associated with improved PI and GI of soft tissue health in the short term.