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

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, 12 months and 8 years after surgeries.

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