The Effect of Ffree Gingival Graft on Keratinized Mucosa Width inThin-Gingiva Type Patients

Zhen Zhang （ Shaanxi Provincial People’s Hospital, Department of Stomatology, Shaanxi, Xi’an, 710068, China ）

Ru Wang （ Shaanxi Provincial People’s Hospital, Department of Stomatology, Shaanxi, Xi’an, 710068, China ）

Hong Liu （ Shaanxi Provincial People’s Hospital, Department of Stomatology, Shaanxi, Xi’an, 710068, China;Sinopharm Tongmei General Hospital,Department of Stomatology, Shanxi, Datong, 037000, China ）

Abstract

Objective: To evaluate the clinical efficacy and safety of free gingival graft (FGG) in increasing keratinized mucosa width (KMW) among patients with thin-gingiva type, and to provide evidence-based guidance for periodontal plastic surgery in patients with thin gingival phenotype. Methods: A total of 72 patients with thin-gingiva type and insufficient keratinized mucosa (KMW < 2 mm) admitted to our hospital from January 2022 to December 2023 were enrolled and randomly divided into a control group (36 cases, conventional periodontal treatment) and an observation group (36 cases, FGG on the basis of conventional treatment). All patients were diagnosed with thin-gingiva type (gingival thickness ≤ 1.0 mm). The observation group received standardized FGG surgery with palatal autogenous grafts. All patients completed 6 months of follow-up. The primary outcome was KMW at baseline, 1, 3, and 6 months postoperatively. Secondary outcomes included gingival thickness (GT), gingival recession depth (GR), plaque index (PI), gingival index (GI), probing depth (PD), clinical attachment level (CAL), patient-reported pain score (VAS), aesthetic satisfaction, and adverse events. Results: At 1, 3, and 6 months postoperatively, KMW and GT in the observation group were significantly higher than those in the control group (P < 0.05), while GR, PI, GI, and PD were significantly lower (P < 0.05). The observation group showed stable soft tissue morphology and high graft survival rate (97.22%). Postoperative pain was mild and well-tolerated, with no severe complications such as massive bleeding, infection, or graft necrosis. Conclusion: For patients with thin-gingiva type, FGG can significantly and stably increase keratinized mucosa width, improve gingival phenotype, reduce gingival recession and inflammation, and show favorable safety and patient satisfaction. It is a reliable surgical method for keratinized tissue augmentation in thin-gingiva individuals and is worthy of clinical promotion.

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