Comparison of Free Gingival Graft and Modified Apical Repositioned Flap Techniques to Create Attached Gingiva: Long-Term (2 Years) Retrospective Study

Abstract

Objective: An ideal anatomical component for maintaining gingival health is the attached gingiva. Increasing the width of the attached gingiva can be achieved using the predictable surgical methods of the modified apically repositioned flap (MARF) and the free gingival graft (FGG). Methods: Fifteen (female) systemically and periodontally healthy patients were enrolled for this study. The treatment of a total of 21 teeth with recession in the lower jaw, absence of bone dehiscence, and attached gingiva ranging from a minimum of 0.5 mm to a maximum of 1.5 mm was conducted through FGG and modified apical positioned flap techniques. These procedures were randomly selected. Pocket depth on probing, gingival recession (GR), clinical attachment loss, bleeding index on probing, attached gingival width (AGW), keratinized tissue width and plaque index values were recorded before the surgical procedure and repeated at the 3rd month, 1st and 2nd years. Results: The changes in GR levels at baseline, 3 months, first and second year in both the FGG and MARF groups were statistically significant (p=0.001; p<0.05). The changes observed in AGW levels at baseline, 3 months, first and second year in both MARF and FGG groups were statistically significant (p=0.001; p<0.05). Conclusion: Both techniques have been shown to result in a statistically significant increase in the width of keratinized tissue and the amount of attached gingiva in the long term.

Keywords

• free gingival graf
• apically repositioned flap
• attached gingiva