Efficacy of Gingival Grafts During the Implantation Process on the Peri-implant Mucosa
Condition: Dental Implants; Transplants
Study type: Interventional

Summary: 
      This study aims to compare the changes in the peri-implant mucosa during the application of
      two soft tissue grafting methods, which are free gingival graft (FGG) and connective tissue
      graft (CTG) taken from the palatine in terms of the width of the keratinized mucosa and the
      thickness of the peri-implant soft tissues.
    

Detailed description: 
      The presence of adequate width of the keratinized gingiva may be necessary in some special
      cases such as the presence of fixed prostheses on the teeth with sublingual margins or peri
      implants. There is an association between insufficiency of the keratinized tissues peri
      implants with greater plaque accumulation, signs of inflammation, soft tissue recession, and
      loss of attachment. The sample will consist of 33 dental implant sites and divide randomly
      into three groups: Group I (Experiential, n=11): FGG; Group II: (Experiential, n=11): CTG;
      and Group III: (Control, n=11): No procedure will be done to improve the quality of the
      peri-implant tissues. The width of the keratinized gingiva will be measured preoperative with
      a UNC-15 and the thickness of the peri-implant soft tissues will be measured clinically by
      direct transgingival propping method. These measurements will be repeated after 1 and 3
      months.
    

Intervention name(s): Efficacy of free gingival grafts during in the increasing of peri-implant keratinized tissue width and soft tissues thickness; Efficacy of connective tissue grafts during in the increasing of peri-implant keratinized tissue width and soft tissues thickness; No types of grafts will be made to improve the quality of the peri-implant mucosa
Intervention type(s): Other; Other; Other
Intervention description(s): Two vertical incisions will be made in the previously elevated flap against the placed implant , where these two incisions will be 10 mm apart from each other, and the free graft to will be placed in this distance (10 x 10 mm). The graft will be obtained from the donor site (the hard palate), and will be thinned to obtain a regular graft with the required thickness. After that, the graft will be moved to its correct place accurately, while avoiding leaving a distance between the graft and the tissue underneath, and the graft will be sutured well to ensure its stability and correct placement.; Vertical incisions will not be made in the previously elevated flap against the placed implant, where there is no need to suture the flap apically of the grafting place because the graft will be covered with it after fixing it in place. The area will be washed with the serum to remove the clot before fixing the graft.The graft will be obtained from the donor site according to the previously mentioned method. Then the epithelium will be removed to leave the connective tissue underneath, and then the graft will be moved to its place (buccally dental implant site) and the flap will be sutured over it.; The simple suturing of the two surgical incisions will be done after the completion of the dental implant process, with no procedure will be made to improve the quality of the peri-implant mucosa.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Triple (Participant, Investigator, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Keratinized Mucosa; Connective Tissue Graft; Free Gingival Graft