Gingival augmentation procedures have long been used in clinical practice and appear as an important factor for maintaining periodontal health. The use of FGG can safely increase the keratinized tissue width and modify the periodontal biotype (Fig. 10.8).
Although the results of FGG may be improved over time by the coronal displacement
of the gingival margin (creeping attachment), the amount of this “beneficial” out- comes may not be anticipated [5, 6]. On the other hand, some degree of soft tissue shrinkage may be anticipated during the initial phase of healing, as well as during long-term follow-up. The available evidence suggests that this KT contraction seems more evident at implant sites (up to 50%) in the short-term (up to 3 months) [7]. For natural teeth, nearly 82% of KT gain achieved at short-term (i.e., 6 months) may be maintained long-term (i.e., up to 25 years). With respect to implant sites, early animal [47] and human studies [48, 49] reported no correlation between implant success and the presence of keratinized mucosa (KM). In contrast, recent systematic reviews con- cluded that an inadequate width of peri-implant KM is associated with more plaque accumulation, signs of inflammation, soft tissue recession, and attachment loss [2, 3, 18, 50]. Furthermore, the peri-implant mucosa appears to possess less potential for an immune response against external irritants (plaque accumulation) [51].
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© Springer Nature Switzerland AG 2020 S. Nares (ed.), Advances in Periodontal Surgery, https://doi.org/10.1007/978-3-030-12310-9_11 D. H. Wong (*)
Private Practice in Periodontics and Dental Implants, Tulsa, OK, USA University of Oklahoma College of Dentistry, Oklahoma City, OK, USA e-mail: david@tulsagums.com, info@tulsagums.com
11
Mucogingival and Periodontal Plastic Surgery: Lateral Sliding Flaps
David H. Wong