Early-stage success of FGG application in different gingival phenotypes

INTRODUCTION: The free gingival graft (FGG) is frequently utilized to enhance insufficient keratinized gingival width. The success of FGG procedures may vary depending on different factors such as graft dimensions, shrinkage rate, and the formation of creeping attachment. However there are limited information about the effect of phenotype of recipient site on clinical success. In this paper, we present the clinical outcomes of FGG procedures performed on two patients exhibiting thin and thick gingival phenotypes in the recipient sites.

CASE DESCRIPTION: Two non-smoking, systemically healthy patients were referred due to aesthetic concerns related to gingival recession defects in the mandible. Gingival pheno- types were evaluated using the probing method, revealing thin gingiva in a female patient with RT2 recession and thick gingiva in a male patient with RT3. Initial periodontal treat- ments were administered following periodontal splinting. Subsequent FGG operations were performed under local anesthesia and postoperative changes were monitored dur- ing a 6-month follow-up period. Accordingly both phenotypes resulted in root coverage with an increase in the width of attached gingiva. Patients were satisfied both aesthetically, functionally. As an interesting outcome, the thicker gingival phenotype exhibited more pronounced creeping attachment. DISCUSSION: The thick gingival phenotype, is reportedly more resistant to mechanical trauma. Nevertheless, there is limited information regarding the impact of recipient site thickness on the clinical outcomes of FGG procedures. CONCLUSION/CLINICAL SIGNIFICANCE: In the cases pre- sented, FGG procedures increased keratinized tissue in both thin and thick gingival phenotypes during early follow-up. Thicker sites showed higher creeping attachment. Long-term studies needed to assess recipient site phenotype and FGG dimensions’ impact