A Modified Free Gingival Graft Technique In Vertical And Horizontal Soft Tissue Augmentation Before Dental Implantation: A Randomized, Split-Mouth, Controlled Clinical Trial

The presence of a sufficient amount of keratinized tissue around dental implants is directly related to their success, facilitates the following restorative procedures, and obtains satisfactory cosmetic results. This study aims to investigate the effectiveness and predictability of different treatment modalities to gain keratinized tissue (KT) in partial edentulous jaws prior to dental implant placement; modified free gingival graft (MFGG), and connective tissue graft (CTG). Materials and Methods: A total of 14 (age range between 25 and 58 years) partially edentulous patients (28 sites) with insufficient zones of keratinized tissue at the prospective implant positionswere included in this study, two treatment modalities were performed in the lower jaw: MFGG, and CTG. MFGG and CTG were applied in the premolar and molar positions randomly. Assessed outcomes up to 6 months postsurgery included changes in width and thickness of keratinized tissue. Results: After 6 months of follow-up,changes in keratinized tissue width demonstrated an increase of 2.29 ± 1.6 mm in connective tissue graft, whereas modified free gingival graft showed an increase of 3.95 ± 1.25 mm, on the other hand changes in keratinized tissue thickness demonstrated an increase of 0.85 ± 0.5 mm in connective tissue graft, whereas modified free gingival graft showed an increase of 0.71 ± 0.4 mm. Conclusion: The two methods were suitable to increase the width and thickness of KT over a 6-month period, although CTG alone rendered roughly 34% less gain at KT width compared to MFGG.