Restoration of Gingival and Esthetic Deformities Following Flap Advancement: The Physiologically Pigmented Gingival Graft—A Case Report

Abstract

The coronal advancement of surgical flaps and subsequent shift of the mucogingival junction during bone augmentation procedures are common. These mucogingival alterations may become a challenge to manage in the maxillary anterior region among patients with a high lip line upon smiling or high esthetic demands. To further complicate matters, the presence of physiologic gingival pigmentation in the esthetic zone creates challenges of its own. In this case, a free gingival graft from the buccal gingiva of the maxillary molars was used to correct the mucogingival deformity created from a guided bone regeneration procedure.

The Modified Apically Repositioned Flap Technique and Its Potential to Regain Gingival Melanin Pigmentation

“…8 Although, various surgical procedures have been described to eliminate gingival pigmentation for esthetic reasons [9][10][11][12][13][14][15][16] only a few articles are available on techniques that promote regaining gingival pigmentation on a predictable basis. 17,18 When free grafts are used to increase the dimension of attached gingiva in patients with melanin pigmentation, the final appearance tends to be a light and pallid tissue, which may be considered a poor color match. 19 Recently introduced in the literature, [20][21][22] the Modified Apically Repositioned Flap does not require a palatal donor source and the surgical technique creates a wound completely surrounded by keratinized tissue.…”