Longitudinal evaluation of free autogenous gingival grafts

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Abstract
The necessity for and effectiveness of the free, autogenous gingival graft in maintaining the periodontal attachment to teeth is determined. Ninety-two patients with bilateral facial surfaces of inadequate keratinized gingiva had a free, autogenous gingival graft placed on one of the facial surfaces (experimental side), while the contralateral side served as the control. Measurements were recorded from the CEJ [cemento-enamel junction] to the free gingival margin, base of the gingival sulcus and mucogingival junction on the mid-facial of selected teeth. The gingival index and plaque index were also evaluated. A total of 107 grafts were performed and followed from 6 mo. to 2 yr post grafting. Patients were recalled (scaling, root planing, plaque control instruction) and clinical parameters such as pocket depth, recession and attachment level were measured at 3 and 6 mo. intervals. Experimental (grafted) and control (unoperated) sides showed marked reduction in the gingival index and plaque index. Neither side demonstrated further attachment loss. Minimizing inflammation is probably sufficient to maintain attachment levels despite the width of keratinized attached gingiva.