Editorial Type:
Article Category: Research Article
 | 
Online Publication Date: 01 Apr 2010

Free Gingival Graft Immobilization: A Pilot Study on a Newly Designed Stent

DMD, MS,
DMD, MS,
DDS, and
DDS
Page Range: 123 – 130
DOI: 10.1563/AAID-JOI-D-09-00034
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Abstract

The presence of adequate gingiva with firm attachment to the underlying periosteum and bone is important for the overall long-term success of implant-supported oral rehabilitation. In the presence of an atrophic edentulous mandible, peri-implant soft tissue management is a challenging task. Therefore, mucosal grafts are sometimes necessary in patients with insufficient attached gingiva around abutments. Immobilization of this graft is mandatory for its survival. The study design included 5 edentulous patients with inadequate attached gingival zone, all candidates for implant surgery and free gingival graft. In the first surgery the implants were inserted, and in the second operation a free gingival graft was obtained from the palate and sutured to the mandibular site. A newly designed stent was applied for the stabilization of the graft. Two to 3 weeks after the second surgery, the stents were removed and the attached gingival width was measured. Long-term evaluations were performed to follow the survival of the graft. All grafts were intact at the time of stent removal. In all cases, the long-term evaluations revealed adequate attached gingiva around the implant. It may be concluded that immobilization of free gingival graft in the recipient site increases its success rate and its survival rate. The application of the newly designed stent can serve as a proper and easy immobilizer for peri-implant soft tissue management.

Copyright: American College of Veterinary Internal Medicine
Figures 1–3
Figures 1–3

Figure 1. Implanted site has no keratinized gingiva. Figure 2. Methyl methacrylate acrylic resin stent was formed over the cast and cured. Figure 3. The finished and polished stent. Snapped temporary cap was used in this case.


Figures 4–9
Figures 4–9

Figure 4. The flap sutured apically to prepare a recipient site for free gingival graft. Figure 5. Harvesting free gingival graft from the palate. Figure 6. The free gingival graft sutured to the recipient site. Figure 7. The stent placed over the abutments. Adaptation achieved using a periodontal dressing. Figure 8. The grafted site 10 days post operation. Figure 9. The grafted site 12 months post operation.


Contributor Notes

Department of Oral and Maxillofacial Surgery, School of Dental Medicine, Azad University of Tehran, Tehran, Iran.
Department of Prosthodontics, Tehran University of Medical Sciences, Tehran, Iran.
Private practice, Tehran, Iran.
*Corresponding author, e-mail: psadr_dds@yahoo.co.uk
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