The relationship between success of free gingival grafts and transplant thickness. Revascularization and shrinkage--a one year clinical study.

The purpose of this clinical investigation was to determine what effects the thickness of a free gingival graft has on the processes of revascularization and shrinkage. With the aid of a Mucotome, very thin, thin, and intermediate thickness grafts were excised from the palate. These were placed in the mandible or maxilla of patients with insufficient attached gingiva. Vertical graft shrinkage was measured at 15, 30, 90, and 360 days after surgery. Angiographic studies were made on 24 healing grafts. From the day of grafting to 360 days afterward the percentages of shrinkage were: very thin, 45%; thin, 44%; intermediate, 38%. The angiographic study demonstrated that rapid revascularization can be expected when uniform grafts of thin to intermediate thickness are placed on a periosteal recipient site which has been carefully freed of loose connective tissue and muscle attachments. An uneven, thick graft placed on a site of denuded bone favored a prolonged period of revascularization and delayed healing.