Various Techniques to Increase Keratinized Tissue for Implant Supported Overdentures: Retrospective Case Series

Abstract

Purpose. The purpose of this retrospective case series is to describe and compare different surgical techniques that can be utilized to augment the keratinized soft tissue around implant-supported overdentures. Materials and Methods. The data set was extracted as deidentified information from the routine treatment of patients at the Ashman Department of Periodontology and Implant Dentistry at New York University College of Dentistry. Eight edentulous patients were selected to be included in this study. Patients were treated for lack of keratinized tissue prior to implant placement, during the second stage surgery, and after delivery of the final prosthesis. Results. All 8 patients in this study were wearing a complete maxillary and/or mandibular denture for at least a year before the time of the surgery. One of the following surgical techniques was utilized to increase the amount of keratinized tissue: apically positioned flap (APF), pedicle graft (PG), connective tissue graft (CTG), or free gingival graft (FGG). Conclusions. The amount of keratinized tissue should be taken into consideration when planning for implant-supported overdentures. The apical repositioning flap is an effective approach to increase the width of keratinized tissue prior to the implant placement.

Retrospective case series analysis of vestibuloplasty with free gingival graft and titanium mesh around dental implant

“…The median relapse rate of KG in this study was still 48.3%. This relapse rate was similar to that of previous studies (38%-45%) 10 . Therefore, the technique presented in this study could achieve an acceptable amount of KG despite the use of mesh over the graft.…”

Prosthetic Rehabilitation in Older Adult with Free Gingival Graft: Case Report

“…The FGG is considered a successful, predictable technique [29] that can prevent the development of hard and soft tissue problems during rehabilitation with implants [30]. This procedure can be performed prior to the placement of the implant, during the second step of implant surgery or after the placement of the definitive prosthesis [29]. Grafting prior to implant placement or during the second phase of surgery can result in a longer wait time before [31].…”

Free Gingival Graft to Increase Keratinized Mucosa after Placing of Mandibular Fixed Implant-Supported Prosthesis

“…Free gingival graft is a successful and predictable technique [ 19 ] that could prevent hard and soft tissue problems developed after implant rehabilitation [ 20 ]. This procedure can be performed previous to implant placement, during the second stage surgery in implants or after placing of the final prosthesis [ 19 ].…”

“…Free gingival graft is a successful and predictable technique [ 19 ] that could prevent hard and soft tissue problems developed after implant rehabilitation [ 20 ]. This procedure can be performed previous to implant placement, during the second stage surgery in implants or after placing of the final prosthesis [ 19 ]. Free gingival graft previous to implant placement or during the second stage surgery can result in a greater waiting time for realization of rehabilitation treatment [ 21 ].…”

“…However, with adequate medication, stabilization of the surgical cement, obtained in this case by the use of both prostheses, and a good follow-up during the first 15 days of healing, we can minimize this limitation. In addition, some percentage of shrinkage should be expected and periodical controls must be performed [ 19 , 24 ].…”