Free Gingival Grafting to Increase the Zone of Keratinized Tissue around Implants

Purpose: The importance of an adequate width of attached gingiva around periodontally affected teeth has been well-documented. However, there is no consensus regarding the relationship between the width of keratinized tissue and the health of peri-implant tissues. Clinicians in general prefer to provide enough keratinized mucosa around dental implants for long-term implant maintenance. There are various methods of increasing the width of keratinized tissue around implants at various stages of treatment. This article aims at presenting a case report where free gingival grafting was done prior to implant placement to predictably increase the width of keratinized tissue and thus enhance the long-term success of the implants. Methods: Free gingival grafting was done in the edentulous region prior to implant placement to increase the width of keratinized tissue at the future implant sites. Two implants were then placed to replace the missing teeth. Results: Free gingival grafting resulted in an increase in the keratinized tissue at the implant sites and also favorably increased the vestibule depth. Clinically healthy keratinized tissue was achieved and maintained around both implants. The patient was able to adequately maintain oral hygiene, with no discomfort. Conclusion: The free gingival graft can be used to increase the width of keratinized tissue and increase the depth of the vestibule around implants, thus favoring their long-term prognosis.