SUBEPITHELIAL CONNECTIVE TISSUE GRAFT SURGERY IN DIFFERENT PERIODONTAL AND PERI-IMPLANT CLINICAL SITUATIONS: A CASE SERIES

Abstract

The absence of keratinized gingiva is associated with an increased propensity of the appearance of gingival recession, gingivitis, periodontitis, mucositis, peri-implantitis, and discomfort during chewing and brushing, making it difficult to maintain periodontal and peri-implant health. Patients with a band of keratinized tissue less than 2mm around implants have higher rates of plaque accumulation, reinforcing the importance of surgical interventions to improve local anatomy, reduce probing depth and prevent gum disease. Although xenogenic alternatives exist, autogenous grafting still generates superior results. This work exposes the main indications of, supported by a collection of clinical cases, using the subepithelial gingival graft technique, in which the graft, composed of epithelium and connective tissue, is submerged in vascularized tissue, reducing the risk of necrosis and yielding better aesthetic results and improved post-operative comfort in comparison to the classic free gingival graft. This surgical procedure has been called periodontal or peri-implant vestibuloplasty.