The sites treated with gingival-augmentation surgery showed a tendency for coronal displacement of the gingival margin with a reduction in recession. The contralateral untreated sites showed a tendency for apical displacement of the gingival margin with an increase in the existing recessions.

Sites treated with GAPs resulted in coronal displacement of GM with RecRed up to complete root coverage, whereas contralateral untreated sites showed a tendency to increase in existing recession or develop new recession during the 18- to 35-year follow-up.

Soft tissue augmentation procedures may modify the biologic remodeling of periodontal dimensions over time associated with aging. Use of FGGs may promote more favorable KT dimensions and improve marginal tissue recession.

Background: Gingival augmentation procedures are indicated primarily to increase an insufficient amount of gingiva and sometimes to halt the progression of gingival recession. The aim of this retrospective long-term study was to evaluate changes in the amount of keratinized tissue (KT) and in the position of the gingival margin after free gingival graft procedures over a period of 10 to 25 years.Methods: One hundred three subjects presenting with 224 sites completely lacking attached gingiva associated with gingival recessions were treated in a private practice. The experimental sites were treated with gingival augmentation procedures (free gingival grafts). The grafts were positioned at the presurgical level of the gingival margin or in a submarginal position. Clinical variables, including recession depth, amount of KT, and probing depth (PD), were measured at baseline (T 0 ), 1 year after surgery (T 1 ), and at the end of the followup period (10 to 25 years) (T 2 ) and analyzed using descriptive statistics and multilevel models.Results: From T 0 to T 1 , the gingival margin shifted coronally 0.8 mm, and KT increased 4.2 mm. From T 1 to T 2 , the gingival margin shifted coronally 0.6 mm, and the overall KT decreased 0.7 mm. PD remained stable.Conclusion: Gingival augmentation procedures performed in sites with an absence of attached gingiva associated with recessions provide an increased amount of KT associated with recession reduction over a long period of time. J Periodontol 2008;79:587-594.

Background The aim of this long‐term case series was to assess the development/prevalence of non‐carious cervical lesions (NCCLs) at sites that have and have not been treated with gingival augmentation following free gingival graft (FGG). Methods Fifty‐two patients had at least one test and one control site: 1) test site showing absence of attached gingiva (AG) associated with gingival recession (GR) treated with FGG; and 2) contralateral site with or without AG. Patient/tooth/site‐associated variables were recorded for each tooth/site at baseline (T0), 12 months after surgery (T1), during the follow‐up period (T2) (15 to 20 years), and at the end of the follow‐up period (T3) over 25 to 30 years. Mixed‐effects logistic regression was used throughout the study. Results Forty‐nine patients/130 sites were available for analysis at T2 whereas 44 patients/120 sites at T3. Twenty‐two NCCLs >0.5 mm were restored in the test sites and in 35 in the untreated sites. The development of NCCL over time appeared associated with sites with attached KT <2 mm (i.e., odds ratio [OR]: 3.80 [P = 0.045] and 3.47 [P = 0.046], 15‐ to 20‐ and 20‐ to 30‐year follow‐ups, respectively), as well as to teeth presenting a thin/non‐modified periodontal phenotype (i.e., OR: 3.53 [P = 0.037] and 5.51 [P = 0.008], 15‐ to 20‐ and 20‐ to 30‐year follow‐ups, respectively). Conclusions Periodontal phenotype modification achieved by FGG may prevent the development/progression of NCCL. Evidence suggests that the thickness and width of the AG had a direct influence on the need of restoring these lesions during the 25‐ to 30‐year observation period.

A fibrin-sealing system consisting of symmetrical flap and graft procedures versus silk sutures in a split-mouth clinical trial was tested in 51 patients. Clinical parameters and operative times were recorded and compared. In clinical use, the fibrin glue provided quick hemostasis and adequate tissue adhesion on the whole inner surface of grafts or flaps. Its use saved remarkable amounts of time and made it easier to fix tissues in difficult areas. The time saved ranged from 3 to 19.5 minutes per procedure, and 1 to 8.5 minutes per tooth. The convenience of the fibrin glue was especially appreciated in pedicle flap procedures.

Mucogingival interceptive surgery is an effective approach to conserve the keratinized buccal gingiva of ectopically erupting premolars.

Mucogingival interceptive surgery is an effective technique to maintain keratinized tissue in correspondence with buccally-erupted teeth.