Longitudinal evaluation of free autogenous gingival grafts

This study was designed to determine the necessity for and effectiveness of the free autogenous gingival graft in maintaining the periodontal attachment to teeth. Ninety-two patients with bilateral facial surfaces of inadequate keratinized gingiva had a free autogenous gingival graft placed on one of the facial surfaces (experimental side) while the contralateral side served as the control. Measurements were recorded from the CEJ to the 1) free gingival margin, 2) base of the gingival sulcus, and 3) mucogingival junction on the mid-facial of selected teeth. The Gingival Index and Plaque Index (Löe 1967) were also evaluated. A total of 107 grafts were performed and followed from 6 months to 2 years post grafting. Patients were recalled (scaling, root planing, plaque control instruction) and clinical parameters such as pocket depth, recession and attachment level were measured at 3- and 6-month intervals. Both experimental (grafted) and control (unoperated) sides showed marked reduction in the Gingival Index and Plaque Index. Neither side demonstrated further attachment loss. it would appear that minimizing inflammation is sufficient to maintain attachment levels despite the width of keratinized attached gingiva.