Peri-Implant Soft Tissue Augmentation With FGG In Posterior Mandible

Keratinized tissue (KT) is essential for maintaining peri-implant health and stability, particularly in the posterior mandible where thin mucosa and high occlusal forces can lead to complications such as peri-implantitis. Free gingival graft (FGG) is a well-established technique for increasing KT width around implants. This case series include several modified FGG methods for KT augmentation in the posterior mandible. Ten patients with insufficient KT around posterior mandibular implants were included. All patients underwent FGG procedures to augment KT. Clinical measurements of KT width (KTW) were taken preoperatively and at 6 months post-surgery. The modified FGG was increased 1.1 to 1.5 times in length. The mean KTW increased from 1.2 mm preoperatively to 3.5 mm at 6 months. No complications such as graft exposure or infection were reported. The FGG technique effectively increased KTW, providing a stable and healthy peri-implant environment. The increased KT width helps resist mechanical and bacterial challenges, reducing the risk of peri-implant inflammation and bone loss. However, FGG may be associated with donor site morbidity. Alternative materials such as xenogeneic collagen matrix (XCM) have been explored to minimize these drawbacks while achieving similar outcomes. FGG is a reliable method for augmenting KT around posterior mandibular implants, significantly improving peri-implant health and stability. This technique is particularly beneficial for patients with thin biotype and high occlusal forces in the posterior mandible. Future research should explore alternative materials and methods to further enhance clinical outcomes and patient satisfaction.