|
KMID : 1034220200120010032
|
|
Journal fo Korean Academy of Osseointegration
2020 Volume.12 No. 1 p.32 ~ p.41
|
|
|
Free gingiva graft/apically positioned flap for keratinized gingiva augmentation following horizontal ridge augmentation: case report
|
|
Seo Young-Wook
Hong In-Pyo
Jeon Su-Hee
Song Young-Woo
Cha Jae-Kook
Paik Jeong-Won
Jung Ui-Won
Choi Seong-Ho
|
|
|
Abstract
|
|
|
|
Insufficient thickness of keratinized gingiva and shallow oral vestibule around dental implants may hamper hygienic control of patients. Lack of oral hygienic control can cause peri-implant disease. To secure sufficient keratinized gingiva around implant, apically positioning flap with or without free gingival graft can be choice of treatment. (Case 1) A 66 year-old female patient was planned to place implant on upper left first premolar and first molar area, and prosthetically reconstructed with i24 = 26. In clinical and radiographic analysis, 1 to 2 mm of narrow keratinized gingiva and insufficient alveolar bone dimension was found. Implant placement was done with guided bone regeneration(GBR). In second surgery, apically positioning flap with free gingival graft was done simultaneously. The width of keratinized gingiva was increased to 3 to 4 mm and well maintained, (Case 2) A 74 year-old female patient was planned to place implant on lower right second premolar and first molar area. In clinical and radiographic analysis, insufficient alveolar bone dimension and 1 to 2 mm of narrow keratinized gingiva was found. Implant placement was done with guided bone regeneration (GBR). In second surgery, apically positioning flap was done simultaneously without additional graft. The width of keratinized gingiva was increased to 3 to 4 mm and well maintained. Both apically positioning flap with and without free gingival graft showed stable and sufficient gaining of keratinized gingiva around implant fixture. Loss of keratinized tissue due to alveolar bone resorption and flap releasing in GBR procedure was recovered by apically positioning flap. Sufficient keratinized gingiva over 2 mm width was secured before final prosthesis. Both apically positioned flap with and without free gingiva graft can be adequate treatment for lack of keratinized gingiva. Using free gingival graft have advantage in predictability of outcome, and apically positioning flap without graft have advantage in patient morbidity. Considering clinical situation, both treatment can be adequate choice for securing keratinized gingiva.
|
|
|
KEYWORD
|
|
|
Free gingiva graft/apically positioned flap, Keratinized gingiva augmentation, Guided bone regeneration
|
|
|
FullTexts / Linksout information
|
|
|
|
|
Listed journal information
|
|
|
|