Vertical Strip Gingival Graft: A New Technique for Gingival Augmentation A pilot study

Abstract

Statement of Problem: Although no minimum width of attached gingiva has been established as a standard for gingival health; gingival augmentation has been carried out because of many reasons. There are numerous methods for widening keratinized attached gingiva. Purpose: This study is to present "Vertical Strip Gingival Graft Technique" as an attempt to improve methods of gingival augmentation. Materials and Methods: In a before-after clinical trial 12 systematically healthy patients with no attached gingiva more than 0.5mm in at least 3 adjacent teeth were entered the study. After recipient bed preparation and harvesting free gingival graft (FGG), the graft was divided in two pieces and each part was fixed in one end of the bed. In this method an area with mean width of 6mm of recipient area, between two grafts, was remained uncovered. In order to determine the efficiency of this technique to augment attached gingiva the distance between stent to mucogingival line (MGL) and widths of attached gingival were used as indicator parameters. Clinical Parameters were measured using Wilcoxon sign rank test before surgery, 6 and 12 weeks after operation. Results: The mean value of stent to MGL in the middle part (between FGGs) at the baseline, 6 and 12 weeks after operation were: 7.82±2.61mm, 11.53±1.4mm, 11.23±1.1mm respectively. The mean width of attached gingiva in those sites at the same intervals was as follows: 0.3±0.2mm, 3.72±1.31mm, and 3.41±1.06mm. Results showed significant increase in the width of attached gingiva (P<0.01). The mean distance of stent to MGL between baseline and 6 week's data; and baseline and 12 week's also showed significant changes (P=0.001). Conclusion: With respect to the limitation of this study, by application of "vertical strip gingival graft technique" wider recipient site with less donor tissue can gain keratinized coverage. And as a result of producing smaller wound in the donor site (palate), patients would have less post surgical pain and discomfort.