Free gingival graft

Free Gingival Graft (FGG) is a dental surgery procedure used to correct gum recession and increase the amount of keratinized gingiva around teeth or dental implants. This procedure is commonly indicated for patients with insufficient gingival tissue, which can lead to increased sensitivity, higher risk of root decay, and aesthetic concerns. The technique involves the transplantation of a piece of gingival tissue from the palate or another donor site to the area around the tooth where additional gum tissue is needed.

Indications

Free gingival grafts are primarily indicated for:

• Increasing the width of attached gingiva
• Covering exposed root surfaces due to gum recession
• Enhancing aesthetic outcomes in anterior regions
• Preventing further recession
• Creating a more favorable environment for oral hygiene practices

Procedure

The FGG procedure is typically performed under local anesthesia. It involves the following steps:

1. A recipient site is prepared at the area of gingival insufficiency by creating a split-thickness flap.
2. A donor graft is harvested from the palate, ensuring to include a layer of epithelium and connective tissue.
3. The donor graft is then precisely adapted and sutured onto the recipient site.
4. The donor site on the palate is either left to heal by secondary intention or covered with a healing dressing.

Advantages and Disadvantages

Advantages:

• Provides a stable increase in the amount of keratinized tissue
• Reduces further recession and bone loss around teeth and implants
• Improves aesthetic appearance and patient comfort

Disadvantages:

• Requires a surgical procedure with associated discomfort and healing time
• Potential for color mismatch between the graft and surrounding tissues
• Limited by the amount of available donor tissue

Postoperative Care

Postoperative care is crucial for the success of a free gingival graft. Patients are advised to:

• Avoid brushing or flossing the surgical area until it has adequately healed
• Use antimicrobial mouth rinses to help control plaque
• Attend follow-up appointments for monitoring and removal of sutures
• Maintain good oral hygiene practices to support the healing process

Complications

Complications are rare but can include:

• Graft failure or partial loss
• Infection at the donor or recipient site
• Excessive bleeding
• Pain and discomfort

Conclusion

The Free Gingival Graft is a reliable and effective surgical technique for increasing the amount of keratinized tissue around teeth and implants, thereby enhancing periodontal health and aesthetics. Despite its disadvantages, when properly indicated and executed, FGG can significantly improve patient outcomes.