Case Report
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Treatment of Implants with Inadequate Attached Gingiva with Free Gingival Graft

Year 2023, , 322 - 326, 15.06.2023
https://doi.org/10.15311/selcukdentj.1239186

Abstract

One of the most important factors for the long-term success of implants is the presence of adequate keratinized gingiva around the implant. Inadequate amount of keratinized gingiva around the implant can lead to inadequate oral hygiene, plaque accumulation, gingival inflammation, bleeding on probing, gingival recession and alveolar bone loss, which may result in long-term implant failure. Among the many surgical techniques used to increase the amount of keratinized gingiva, free gingival graft is the most commonly used method to increase the amount of keratinized gingiva and soft tissue thickness in natural teeth and implant areas. In this case report, the 6-month results of increasing the amount of keratinized gingiva using free gingival graft of implants with inadequate amount of keratinized gingiva of 3 different patients are presented.

References

  • 1. Hu M, Chen J, Pei X, Han J, Wang J. Network meta-analysis of survival rate and complications in implant-supported single crowns with different abutment materials. Journal of Dentistry. 2019;88:103115.
  • 2. Rosen P, Clem D, Cochran D, Froum S, McAllister B, Renvert S, et al. Peri-implant mucositis and peri-implantitis: a current understanding of their diagnoses and clinical implications. Journal of periodontology. 2013;84(4):436-43.
  • 3. Sculean A, Gruber R, Bosshardt DD. Soft tissue wound healing around teeth and dental implants. Journal of clinical periodontology. 2014;41:S6-22.
  • 4. Kim J-J, Lee J-H, Kim JC, Lee J-B, Yeo I-SL. Biological responses to the transitional area of dental implants: Material-and structure-dependent responses of peri-implant tissue to abutments. Materials. 2019;13(1):72.
  • 5. Klinge B, Klinge A, Bertl K, Stavropoulos A. Peri‐implant diseases. European journal of oral sciences. 2018;126:88-94.
  • 6. Schrott AR, Jimenez M, Hwang JW, Fiorellini J, Weber HP. Five‐year evaluation of the influence of keratinized mucosa on peri‐implant soft‐tissue health and stability around implants supporting full‐arch mandibular fixed prostheses. Clinical oral implants research. 2009;20(10):1170-7.
  • 7. Boynueğri D, Nemli SK, Kasko YA. Significance of keratinized mucosa around dental implants: a prospective comparative study. Clinical oral implants research. 2013;24(8):928-33.
  • 8. Buyukozdemir Askin S, Berker E, Akincibay H, Uysal S, Erman B, Tezcan İ, et al. Necessity of keratinized tissues for dental implants: a clinical, immunological, and radiographic study. Clinical implant dentistry and related research. 2015;17(1):1-12.
  • 9. Oh SL, Masri RM, Williams DA, Ji C, Romberg E. Free gingival grafts for implants exhibiting lack of keratinized mucosa: a prospective controlled randomized clinical study. Journal of Clinical Periodontology. 2017;44(2):195-203.
  • 10. Wennström J, Bengazi F, Lekholm U. The influence of the masticatory mucosa on the peri‐implant soft tissue condition. Clinical oral implants research. 1994;5(1):1-8.
  • 11. Kim B-S, Kim Y-K, Yun P-Y, Yi Y-J, Lee H-J, Kim S-G, et al. Evaluation of peri-implant tissue response according to the presence of keratinized mucosa. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 2009;107(3):e24-e8.
  • 12. Grischke J, Karch A, Wenzlaff A, Foitzik MM, Stiesch M, Eberhard J. Keratinized mucosa width is associated with severity of peri‐implant mucositis. A cross‐sectional study. Clinical Oral Implants Research. 2019;30(5):457-65.
  • 13. Zucchelli G, Tavelli L, McGuire MK, Rasperini G, Feinberg SE, Wang HL, et al. Autogenous soft tissue grafting for periodontal and peri‐implant plastic surgical reconstruction. Journal of Periodontology. 2020;91(1):9-16.
  • 14. Small PN, Tarnow DP. Gingival recession around implants: a 1-year longitudinal prospective study. Int J Oral Maxillofac Implants. 2000;15(4):527-32.
  • 15. Wu Q, Qu Y, Gong P, Wang T, Gong T, Man Y. Evaluation of the efficacy of keratinized mucosa augmentation techniques around dental implants: a systematic review. The Journal of prosthetic dentistry. 2015;113(5):383-90.
  • 16. Adibrad M, Shahabuei M, Sahabi M. Significance of the width of keratinized mucosa on the health status of the supporting tissue around implants supporting overdentures. Journal of Oral Implantology. 2009;35(5):232-7. 17. Bouri Jr A, Bissada N, Al-Zahrani MS, Faddoul F, Nouneh I. Width of keratinized gingiva and the health status of the supporting tissues around dental implants. International Journal of Oral & Maxillofacial Implants. 2008;23(2).
  • 18. Perussolo J, Souza AB, Matarazzo F, Oliveira RP, Araújo MG. Influence of the keratinized mucosa on the stability of peri‐implant tissues and brushing discomfort: a 4‐year follow‐up study. Clinical oral implants research. 2018;29(12):1177-85.
  • 19. Wiesner G, Esposito M, Worthington H, Schlee M. Connective tissue grafts for thickening peri-implant tissues at implant placement. One-year results from an explanatory split-mouth randomised controlled clinical trial. Eur J Oral Implantol. 2010;3(1):27-35.
  • 20. Nemcovsky CE, Moses O. Rotated palatal flap. A surgical approach to increase keratinized tissue width in maxillary implant uncovering: technique and clinical evaluation. International Journal of Periodontics and Restorative Dentistry. 2002;22(6):607-12.
  • 21. Elkhaweldi A, Rincon Soler C, Cayarga R, Suzuki T, Kaufman Z. Various techniques to increase keratinized tissue for implant supported overdentures: retrospective case series. International journal of dentistry. 2015;2015.
  • 22. Basegmez C, Ersanli S, Demirel K, Bölükbasi N, Yalcin S. The comparison of two techniques to increase the amount of peri-implant attached mucosa: free gingival grafts versus vestibuloplasty. One-year results from a randomised controlled trial. Eur J Oral Implantol. 2012;5(2):139-45.

Yapışık Dişeti Miktarı Yetersiz İmplantların Serbest Dişeti Greftiyle Tedavisi

Year 2023, , 322 - 326, 15.06.2023
https://doi.org/10.15311/selcukdentj.1239186

Abstract

İmplantların uzun dönem başarıları için gereken en önemli faktörlerden birisi implant çevresinde yeterli keratinize diş eti varlığıdır. İmplant çevresinde keratinize diş eti miktarının yetersiz olması, oral hijyenin istenilen düzeyde sağlanamamasına, plak birikimine, gingival enflamasyona, sondlamada kanamaya, diş eti çekilmesine ve alveoler kemik kaybına neden olabilmekte bu da uzun dönemde implant başarısızlığı ile sonuçlanabilmektedir. Yapışık diş eti miktarını artırmak için kullanılan çok sayıda cerrahi teknik arasından serbest diş eti grefti, doğal dişlerde ve implant bölgelerinde keratinize diş eti miktarı ve yumuşak doku kalınlığını artırmak için en sık kullanılan yöntemdir. Bu olgu sunumunda 3 ayrı hastaya ait, yapışık diş eti miktarı yetersiz olan implantların, serbest diş eti grefti kullanılarak yapışık diş eti miktarı artırımının 6 aylık sonuçları sunulmaktadır.

References

  • 1. Hu M, Chen J, Pei X, Han J, Wang J. Network meta-analysis of survival rate and complications in implant-supported single crowns with different abutment materials. Journal of Dentistry. 2019;88:103115.
  • 2. Rosen P, Clem D, Cochran D, Froum S, McAllister B, Renvert S, et al. Peri-implant mucositis and peri-implantitis: a current understanding of their diagnoses and clinical implications. Journal of periodontology. 2013;84(4):436-43.
  • 3. Sculean A, Gruber R, Bosshardt DD. Soft tissue wound healing around teeth and dental implants. Journal of clinical periodontology. 2014;41:S6-22.
  • 4. Kim J-J, Lee J-H, Kim JC, Lee J-B, Yeo I-SL. Biological responses to the transitional area of dental implants: Material-and structure-dependent responses of peri-implant tissue to abutments. Materials. 2019;13(1):72.
  • 5. Klinge B, Klinge A, Bertl K, Stavropoulos A. Peri‐implant diseases. European journal of oral sciences. 2018;126:88-94.
  • 6. Schrott AR, Jimenez M, Hwang JW, Fiorellini J, Weber HP. Five‐year evaluation of the influence of keratinized mucosa on peri‐implant soft‐tissue health and stability around implants supporting full‐arch mandibular fixed prostheses. Clinical oral implants research. 2009;20(10):1170-7.
  • 7. Boynueğri D, Nemli SK, Kasko YA. Significance of keratinized mucosa around dental implants: a prospective comparative study. Clinical oral implants research. 2013;24(8):928-33.
  • 8. Buyukozdemir Askin S, Berker E, Akincibay H, Uysal S, Erman B, Tezcan İ, et al. Necessity of keratinized tissues for dental implants: a clinical, immunological, and radiographic study. Clinical implant dentistry and related research. 2015;17(1):1-12.
  • 9. Oh SL, Masri RM, Williams DA, Ji C, Romberg E. Free gingival grafts for implants exhibiting lack of keratinized mucosa: a prospective controlled randomized clinical study. Journal of Clinical Periodontology. 2017;44(2):195-203.
  • 10. Wennström J, Bengazi F, Lekholm U. The influence of the masticatory mucosa on the peri‐implant soft tissue condition. Clinical oral implants research. 1994;5(1):1-8.
  • 11. Kim B-S, Kim Y-K, Yun P-Y, Yi Y-J, Lee H-J, Kim S-G, et al. Evaluation of peri-implant tissue response according to the presence of keratinized mucosa. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 2009;107(3):e24-e8.
  • 12. Grischke J, Karch A, Wenzlaff A, Foitzik MM, Stiesch M, Eberhard J. Keratinized mucosa width is associated with severity of peri‐implant mucositis. A cross‐sectional study. Clinical Oral Implants Research. 2019;30(5):457-65.
  • 13. Zucchelli G, Tavelli L, McGuire MK, Rasperini G, Feinberg SE, Wang HL, et al. Autogenous soft tissue grafting for periodontal and peri‐implant plastic surgical reconstruction. Journal of Periodontology. 2020;91(1):9-16.
  • 14. Small PN, Tarnow DP. Gingival recession around implants: a 1-year longitudinal prospective study. Int J Oral Maxillofac Implants. 2000;15(4):527-32.
  • 15. Wu Q, Qu Y, Gong P, Wang T, Gong T, Man Y. Evaluation of the efficacy of keratinized mucosa augmentation techniques around dental implants: a systematic review. The Journal of prosthetic dentistry. 2015;113(5):383-90.
  • 16. Adibrad M, Shahabuei M, Sahabi M. Significance of the width of keratinized mucosa on the health status of the supporting tissue around implants supporting overdentures. Journal of Oral Implantology. 2009;35(5):232-7. 17. Bouri Jr A, Bissada N, Al-Zahrani MS, Faddoul F, Nouneh I. Width of keratinized gingiva and the health status of the supporting tissues around dental implants. International Journal of Oral & Maxillofacial Implants. 2008;23(2).
  • 18. Perussolo J, Souza AB, Matarazzo F, Oliveira RP, Araújo MG. Influence of the keratinized mucosa on the stability of peri‐implant tissues and brushing discomfort: a 4‐year follow‐up study. Clinical oral implants research. 2018;29(12):1177-85.
  • 19. Wiesner G, Esposito M, Worthington H, Schlee M. Connective tissue grafts for thickening peri-implant tissues at implant placement. One-year results from an explanatory split-mouth randomised controlled clinical trial. Eur J Oral Implantol. 2010;3(1):27-35.
  • 20. Nemcovsky CE, Moses O. Rotated palatal flap. A surgical approach to increase keratinized tissue width in maxillary implant uncovering: technique and clinical evaluation. International Journal of Periodontics and Restorative Dentistry. 2002;22(6):607-12.
  • 21. Elkhaweldi A, Rincon Soler C, Cayarga R, Suzuki T, Kaufman Z. Various techniques to increase keratinized tissue for implant supported overdentures: retrospective case series. International journal of dentistry. 2015;2015.
  • 22. Basegmez C, Ersanli S, Demirel K, Bölükbasi N, Yalcin S. The comparison of two techniques to increase the amount of peri-implant attached mucosa: free gingival grafts versus vestibuloplasty. One-year results from a randomised controlled trial. Eur J Oral Implantol. 2012;5(2):139-45.
There are 21 citations in total.

Details

Primary Language Turkish
Subjects Dentistry
Journal Section Case Report
Authors

Yunus Emre Balaban 0000-0002-1754-4296

Sefa Aydındoğan 0000-0003-2980-2691

Publication Date June 15, 2023
Submission Date January 19, 2023
Published in Issue Year 2023

Cite

Vancouver Balaban YE, Aydındoğan S. Yapışık Dişeti Miktarı Yetersiz İmplantların Serbest Dişeti Greftiyle Tedavisi. Selcuk Dent J. 2023;10(4):322-6.