Aesthetic evaluation of free gingival graft applied by partial de-epithelialization and free gingival graft applied by conventional method: a randomized controlled clinical study

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NAZİKER Y., Ertugrul A. S.

Clinical Oral Investigations, vol.27, no.7, pp.4029-4038, 2023 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 27 Issue: 7
  • Publication Date: 2023
  • Doi Number: 10.1007/s00784-023-05029-8
  • Journal Name: Clinical Oral Investigations
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, EMBASE, MEDLINE
  • Page Numbers: pp.4029-4038
  • Keywords: Cosmetic periodontal plastic surgery, Treatment planning, Connective tissue graft(s)
  • Istanbul Medipol University Affiliated: Yes


Objective: The aim of this clinical study was to compare the partially de-epithelialized free gingival grafts (d-FGGs) with the conventional free gingival grafts (FGGs) aesthetically using photographic analysis and Visual Analogue Scale (VAS). Materials and methods: A total of 30 defects were treated in 15 patients with attached gingiva insufficiency. In the split-mouth study, d-FGGs were applied on one side (test group), while FGGs were applied on the contralateral side (control group). Results of clinical periodontal parameters were evaluated in 6-month follow-up, and aesthetic evaluation results were evaluated in 1-, 3-, and 6-month follow-ups. Results: Among the periodontal clinical parameters examined, only the keratinized tissue (KT) width was found to be statistically significantly higher in the test group compared to the control group. In the photo analysis evaluation, the ΔE value at the 3rd month was statistically significantly higher in the test group. In VAS evaluation, there was no significant difference between the two groups in the time periods examined. Conclusion: Photo analysis is an objective, sensitive, reproducible, and safe method that can be used in dentistry and medicine by detecting the slightest changes and giving more detailed and superior results than visual evaluation. The d-FGG application could provide acceptable aesthetic results by providing an appearance compatible with the gingival contour and gingiva in the adjacent region in creating keratinized gingiva. Clinical relevance: While the free gingival graft has color differences with the recipient area, the deep-thelialized gingival graft has a compatible appearance with the recipient area. Partially, de-epithelialized free gingival graft is a method with acceptable aesthetic results. Trial registration: U.S. National Institutes of Health Clinical Trials: NCT04970524