Smoking Effects the FGG Shrinkage Around Posterior Dental Implants: A Prospective Clinical Trial

Objective: To evaluate the effect of smoking on free gingival graft (FGG) dimensions, keratinized mucosa width (KMW) and vestibule sulcus depth following FGG surgery around implants. Methods: Twenty implants with KMW<2mm on buccal sites in twenty patients were included. Measurements of horizontal dimension of FGG, KMW, FGG area, vestibule sulcus depth, and tissue thickness of recipient and donor sites were performed using individual stents during 6 months. The Brunner-Langer model was used for statistical comparisons. Results: KMW, vestibule sulcus depth and tissue thickness of recipient site significantly increased at first month compared to baseline (p<0.05), but no further change was observed at 3 and 6 months (p>0.05). These parameters were not affected by smoking (p>0.05). FGG area decreased at first month in both groups (p<0.05). While no further decrease in FGG area was observed at 3 and 6 months in non-smokers, a significant decrease was determined at 6 months compared to first month in smokers (p=0.0034). The smoker group had more shrinkage in FGG than non-smoker group at 6 months (p= 0.004). Conclusion: Smoking might be a confounding factor for FGG shrinkage but KMW and vestibule sulcus depth do not seem to be affected by smoking following FGG around implants.