title: Free gingival grafts to increase keratinized tissue: a retrospective long-term evaluation (10 to 25 years) of outcomes.
abstract: 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 follow-up 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.
  
  
  CONCLUSIONS
  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.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Agudio
authors.forename: Michele
authors.initials: M
authors.lastname: Nieri
authors.forename: Roberto
authors.initials: R
authors.lastname: Rotundo
authors.forename: Pierpaolo
authors.initials: P
authors.lastname: Cortellini
authors.forename: Giovanpaolo
authors.initials: G
authors.lastname: Pini Prato
mesh_terms: D000293:Adolescent; D000328:Adult; D016301:Alveolar Bone Loss / Q000145:classification; D003774:Dental Plaque Index; D005260:Female; D005500:Follow-Up Studies; D005881:Gingiva / Q000473:pathology / Q000637:transplantation*; D005884:Gingival Hemorrhage / Q000145:classification; D005888:Gingival Pocket / Q000473:pathology / Q000601:surgery; D005889:Gingival Recession / Q000473:pathology / Q000601:surgery*; D005893:Gingivoplasty / Q000379:methods; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000145:classification; D012189:Retrospective Studies; D013524:Surgical Flaps; D014072:Tooth Abrasion / Q000145:classification; D019237:Tooth Cervix / Q000473:pathology; D016896:Treatment Outcome