Shao Yi-Qian, Xiong Zi-Yun, Liu Di-Xin, Tang Si-Min, Chen Li, Xiong Qin, Wu Shuo-Yan, Xuan Dong-Ying
College of Dentistry, Zhejiang Chinese Medical University, Hangzhou, China.
Department of Periodontology, Hangzhou Stomatology Hospital, Hangzhou, China.
Int Dent J. 2025 Apr;75(2):1311-1318. doi: 10.1016/j.identj.2024.09.019. Epub 2024 Oct 20.
The histological and morphological differences in soft tissue between natural teeth and peri-implant may result in different clinical effectiveness to free gingival graft (FGG). This research aims to investigate the different efficacy of FGG in augmenting keratinized tissue width (KTW) between tooth and implant sites while evaluating its medium-term stability over a 2- to 5-year follow-up.
In this study, 29 patients underwent FGG to address insufficient clinical scenarios when KTW <2 mm at the buccal aspect, including 37 implant sites and 33 natural teeth sites both in posterior regions were included. The KTW and gingival margin position (GMP) of these sites was assessed by measuring the intra-oral photographs which were taken at 0 days (T0), 3-month (T1), 6-month (T2), 12-month post-surgery (T3), and 2 to 5 years follow-up (T4).
The results revealed that KTW increased significantly in both groups. However, the natural teeth group showed significantly less graft shrinkage (GS) than the implants group. (Teeth: 2.05 ± 0.51 mm and 25.42% ± 6.45%; Implants: 3.18 ± 0.65 mm and 38.92% ± 5.39%, P <.01). From T1 to T4. The gingival margin coronally advanced by 0.47 ± 0.51 mm and 0.18 ± 0.43 mm for the natural teeth and implants group, respectively (P<.05).
A greater KTW reduction after FGG was observed at implants versus natural teeth. And, the graft surrounding implants after crown restoration was stable for up to 2 to 5 years.
By comparing the changes in KTW around natural teeth and implants following FGG to investigate whether there are differences between them and the degree of differences. Additionally, this allows us to explore whether the restorations impact the effect of FGG. This research can assist clinicians in selecting an appropriate amount of soft tissue during surgery to achieve treatment goals, reduce postoperative discomfort for patients, and enhance predictability in clinicians' ability to increase keratinized tissue. Furthermore, by observing changes in the position of GMP around natural teeth and implants, the effectiveness of FGG in root coverage can be understood, thus improving the predictability of FGG for root coverage.
天然牙与种植体周围软组织在组织学和形态学上的差异，可能导致游离龈瓣移植术（FGG）产生不同的临床效果。本研究旨在探讨FGG在增加牙位和种植体位点角化组织宽度（KTW）方面的不同疗效，并在2至5年的随访期内评估其中期稳定性。
在本研究中，29例患者接受FGG治疗，以解决颊侧KTW<2mm的临床不足情况，其中包括后牙区的37个种植位点和33个天然牙位点。通过测量在术后0天（T0）、3个月（T1）、6个月（T2）、12个月（T3）以及2至5年随访期（T4）拍摄的口腔内照片，评估这些位点的KTW和牙龈边缘位置（GMP）。
结果显示，两组的KTW均显著增加。然而，天然牙组的移植组织收缩（GS）明显低于种植体组。（牙齿：2.05±0.51mm，25.42%±6.45%；种植体：3.18±0.65mm，38.92%±5.39%，P<.01）。从T1到T4，天然牙组和种植体组的牙龈边缘分别向冠方推进了0.47±0.51mm和0.18±0.43mm（P<.05）。
与天然牙相比，FGG术后种植体周围的KTW减少更多。并且，冠修复后种植体周围的移植组织在长达2至5年内保持稳定。
通过比较FGG术后天然牙和种植体周围KTW的变化，研究它们之间是否存在差异以及差异程度。此外，这使我们能够探索修复体是否会影响FGG的效果。本研究可以帮助临床医生在手术过程中选择合适的软组织量以实现治疗目标，减少患者术后不适，并提高临床医生增加角化组织能力的可预测性。此外，通过观察天然牙和种植体周围GMP位置的变化，可以了解FGG在牙根覆盖方面的有效性，从而提高FGG对牙根覆盖的可预测性。
