Vertical and Horizontal Dimensional Evaluation of Sutureless Free Gingival Grafts

Background and Aim: Tissue adhesives can be used as an alternative to conventional sutures in periodontal surgery. The free gingival graft (FGG) is a technique used to increase the zone of keratinized gingiva. The shrinkage of FGGs is a well-known clinical phenomenon. However, to our knowledge, there is no data available regarding the dimensional changes in FGG procedure using non-suturing techniques. The aim of the present study was to evaluate the shrinkage of FGGs, either sutureless or with suturing technique, in both horizontal and vertical dimensions and to calculate the changes in the surface area of the graft at early and delayed time points. Subjects and Methods: The present study was carried out on 26 patients requiring FGG due to lack of keratinized gingiva at the buccal aspect of mandibular incisors. Patients were randomly treated by FGG using either tissue adhesive (test) or suture (control). The graft dimensions were measured and the shrinkage of the graft was calculated at baseline and at day 10, 21 and 180. Results: Significant reductions were observed in horizontal and vertical dimensions at all time-points. When compared to baseline, this difference was statistically significant during the whole study period, except in the test group at day 10. The percentage of vertical shrinkage was significantly lower in the test group at day 10 and 180 when compared to baseline. Conclusions: Present findings indicate that tissue adhesives can reduce the amount of vertical graft shrinkage that occurs following FGG procedures.