This study will compare a new technique of free gingival graft to the original one, in order to evaluate the stability of the graft volume over one year and other variables. Twenty patients will receive the original technique of free gingival graft (controls) and twenty patients will receive the modified technique, in which the free gingival graft is submerged (tests), at the inferior incisors area.
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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
40
Surgical technique (autologous graft): Free gingival graft technique, harvested from palate.
Surgical technique (autologous graft): Original technique of free gingival graft, positioned at the inferior incisors area at the donor area
Surgical technique (autologous graft): Free gingival graft. positioned at the inferior incisors area and covered by a flap at the donor area
Faculdade de Odontologia da USP
São Paulo, São Paulo, Brazil
Apical-cervical width of keratinized tissue after 12 months
Distance between gingival margin and mucogingival junction, in millimeters
Time frame: 12 months
Probing Depth
Distance between gingival margin and bottom of the sulcus / pocket, in millimeters
Time frame: 12 months
Keratinized tissue area
Keratinized tissue area, measured in millimeters
Time frame: 12 months
Keratinized tissue thickness
Keratinized tissue thickness measured in millimeters
Time frame: 12 months
Volume of receiving area
Volume of receiving area
Time frame: 12 months
Complete epithelization of donor area
Area of Epithelization of wound healing, measured in mm2
Time frame: 28 days
Postoperative discomfort
discomfort measured using Visual Analogue Scale
Time frame: 28 days
Gum color
Measured with photographic analysis
Time frame: 12 months
Oral Health Related Quality of Life (OHIP)
OHIp - 14 short version
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Time frame: 12 months
Clinical Attachment Level
Distance between cementum-enamel junction and bottom of sulcus / pocket, measured in millimeters
Time frame: 12 months
Recession
Distance between cementum-enamel junction and gingival margin, measured in millimeters
Time frame: 12 months
Bleeding on probing
percentage of sites which bled upon probing
Time frame: 12 months