Clinical Assessment of Free Gingival Graft Effectiveness on the Maintenance of Periodontal Health

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Abstract
This investigation was undertaken to evaluate the long term clinical effect of free gingival grafts on the periodontal condition. Forty grafts, performed on 34 patients 1 to 8 years ago, were selected. Plaque and gingival indices were determined in the grafted areas. Direct clinical measurements from the cementoenamel junction to: a) margin of the gingiva, b) bottom of the gingival sulcus and c) mucogingival junction were also recorded. Similar examination of contralateral or adjacent 40 nongrafted areas for each patient was also conducted to serve as a control. Tissue mobility of the grafted and control areas was then recorded to the nearest 0.001 inch, using a specially developed device, which exerted a standardized tension of 50 gm perpendicular to the surface of the gingiva. Data was subjected to statistical evaluation to determine the significance of changes in variables between grafted and nongrafted sites. The following conclusions were drawn: 1) The zone of keratinized and attached gingiva, though more apically positioned, is significantly wider in the grafted sites. 2) There are no significant differences between grafted and nongrafted sites with regard to plaque index, gingival index and pocket depth. 3) In both grafted and nongrafted sites, a wider zone of attached gingiva corresponds to a shallower pocket depth. 4) There is a significant positive correlation between mobility of the graft and pocket depth. The present investigation, therefore, indicates that, while the free gingival graft is an effective means to widen the zone of the attached and keratinized gingiva, there is no indication that this increase bears direct influence upon periodontal health.

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