Major considerations on the gingival graft on dental implant: a concise systematic review

Modern implant dentistry uses gingival grafts to promote tissue regeneration around dental implants, ensuring the stability and aesthetics of oral rehabilitation. This study addresses the main types of gingival grafts used, including connective-subepithelial grafts, free gingival tissue grafts, and allogeneic grafts, comparing their clinical indications, advantages, and disadvantages. The connective-subepithelial graft stands out for offering superior aesthetic results, being indicated in visible areas, but requires a donor area, which can increase patient discomfort. Free gingival tissue grafts are effective in increasing keratinized gingiva, essential for peri-implant health, while allogeneic grafts, obtained from tissue banks, eliminate the need for additional surgery, becoming a less invasive option. In addition to the characteristics of the grafts, the study also explores the biomaterials used, such as autogenous, xenogeneic, and allogeneic, analyzing their biocompatibility, osteoconduction, and resorption rate properties, which influence graft integration. Autogenous grafts have high biocompatibility and osteoinductive capacity, while xenogeneic and allogeneic grafts have advantages in terms of accessibility and reduced procedures. The cost and accessibility of graft procedures are important factors in choosing the treatment since the value varies according to the type of graft and the technique applied. Procedures with autogenous grafts tend to be more expensive due to the need for additional surgery, while xenogeneic and allogeneic grafts, which are more accessible, present a balance between cost and effectiveness, especially in health systems with limited coverage. This study provided a comprehensive overview of the indications and limitations of the types of gingival grafts, offering support for the choice of treatments that reconcile health, aesthetics, and cost-effectiveness.