Application Of FGG With Partial Epithelium Removal In Oral Implantology

In dental implantology, inadequate keratinized gingiva (KG) width at implant sites may compromise long-term stability. Conventional free gingival graft (FGG) procedures frequently present challenges including excessive donor site morbidity, unpredictable graft shrinkage, and postoperative complications. This study evaluates a modified FGG technique involving partial epithelium removal to overcome these limitations. Between December 2020 and December 2024, 23 implant patients (10 males, 13 females) with KG deficiency (<2-3mm) were enrolled. The surgical protocol included: 1) Recipient site preparation via split-thickness flap elevation; 2) Harvesting a partial-thickness palatal graft (5-8mm width, 1-1.5mm thickness) with selective de-epithelialization; 3) Graft adaptation and stabilization; 4) Complete flap coverage. Postoperative assessments were conducted at suture removal (7 days), stage-II surgery (3-4 weeks), and annually thereafter. All cases achieved successful graft integration without infection or necrosis. The mean KG width increased to >3mm and remained stable throughout follow-up (1-3 years). Donor site healing was uneventful in all patients. The partial epithelium-removed FGG technique offers advantages including simplified operation, minimal trauma, excellent graft healing, and long-term stability, making it worthy of clinical promotion.