Retained Free Gingival Graft Rugae: A 9‐Year Case Report

Abstract

In the oral cavity, masticatory mucosa covers the hard palate and gingiva. The epithelium of masticatory mucosa is relatively thick compared to other oral tissues. This results in firmness and immobility necessary to withstand the forces of mastication. In the anterior aspect of the hard palate, long papillae within the lamina propria and thick dense collagenous tissue are found under the transverse ridges or rugae. Though palatal rugae are generally avoided during soft tissue grafting, there are few literature references detailing the consequences of transplanting tissue from the anterior palate which contains rugae. The following case report describes retained palatal rugae in a free gingival graft, which had been transplanted to an edentulous ridge 9 years earlier.

Assessment of thickness of palatal mucosal donor site and its association with age and gender

“…[2] and Breault et al .,[24] return of the palatal rugae was observed several months postoperatively. Thus, the canine and premolar areas appeared to be the most appropriate donor site for grafting procedures.…”

The use of free gingival grafts for aesthetic purposes

“…The second bicuspid/first molar area is the site of choice. Selection of the palatal donor site should avoid the rugae areas because they may persist in the grafted tissue for as long as 9 years (10) and consequently compromise aesthetics. Care should also be exercised to avoid the greater palatine foramen area due to potential bleeding and paresthesia.…”

Subjective Evaluation of Lateral Pedicle Graft and Free Mucosal Graft for Donor Site Morbidity and Aesthetics in Localized Gingival Recessions

“…In the present study patients did not complain of any significant difference in any of the two groups which is not in conformity with the other studies. 8,10,11 In a review by Tackas 11 lateral pedicle flap was found to be more esthetic than free mucosal graft.…”