Free gingival graft in combination with apically positioned flap for establishment of keratinized gingiva around the implants: Report of two cases

근단변위판막술과 함께 유리치은이식술을 사용하여 임플란트 주변 각화치은을 증대시킨 2건의 증례 보고

  • Baek, Won-Sun (Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University) ;
  • Cha, Jae Kook (Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University) ;
  • Lee, Jae-Hong (Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University) ;
  • Lee, Jung-Seok (Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University) ;
  • Jung, Ui-Won (Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University)
  • 백원선 (연세대학교 치과대학 치주과학교실, 치주조직재생연구소) ;
  • 차재국 (연세대학교 치과대학 치주과학교실, 치주조직재생연구소) ;
  • 이재홍 (연세대학교 치과대학 치주과학교실, 치주조직재생연구소) ;
  • 이중석 (연세대학교 치과대학 치주과학교실, 치주조직재생연구소) ;
  • 정의원 (연세대학교 치과대학 치주과학교실, 치주조직재생연구소)
  • Received : 2015.12.30
  • Accepted : 2016.03.03
  • Published : 2016.04.01

Abstract

Narrow zone of attached gingiva and shallow vestibule around the implants might contribute to difficulty of cleasing, periimplant mucositis caused by incomplete cleansing and further peri-implantitis. The aim of this case report is to present modification of soft tissue biotype around the implants by free gingival grafts according to timing of surgical intervention and shape of free gingiva. A 44 year-old male patient had a missing area on lower right second molar area with 1 to 2 mm of narrow attached gingiva zone and wanted to be treated by implant placement. In radiographic analysis, there was enough alveolar bone to install an implant, free gingiva from hard palate was grafted following implant placement using double layer flap. The width of attached gingival was increased to 4 to 5mm and well maintained during 5 months of follow up. A 69 year-old female patient also had a missing area on lower right first and second molar area with 1 to 2 mm narrow attached gingiva. Since she had systematically angina pectoris and dental phobia, minimal invasive free gingival graft after implants placement was planned. After 2 months of implant surgery, free gingival graft surgery was performed with healing abutments connection. The grafted gingiva was composed of two strip shaped free gingiva, and they were immobilized by periodontal pack. The width of attached gingival was increased to 4 to 5mm and well maintained during 10 months of follow up. With prosthesis delivery, the patients recovered ideal periodontal environment around implants and masticatory function. In conclusion, periodontal health and masticatory function could be achieved through implant placement and free gingival graft.

Acknowledgement

Supported by : 연세대학교 치과대학

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