Application of apically positioned flap technique on keratinized gingiva reconstruction in implant

To explore the method of apically positioned flap technique (APFT) on buccal keratinized gingiva reconstruction around dental implants and evaluate its clinical outcomes and technical characters.

13 patients, who were insufficient of buccal keratinized gingiva around dental implants but sufficient with alveolar ridge crest tissue or palatal tissue at posterior maxillar, were enrolled in this study. APFT was operated during the phase Ⅱ surgery, by which some tissues were transferred from the alveolar ridge crest or palatal side to the original site of keratinized gingiva. Before APFT surgery and 1, 6 and 12 months after crown restoration, the width and thickness of transferred tissues were measured, gingival index (GI) and bleeding on probing (BOP) were also detected. The results were applied to comparative t-test statistical analysis.

Transferred tissues by APFT showed healthy one month after crown restoration and exhibited characters of keratinized gingiva compared with the adjacent teeth at 6 and 12 months after restoration. Mean value of width of transferred tissue were respectively (3.25 ± 0.40) mm, (3.04 ± 0.34) mm and (2.97 ± 0.32) mm, meanwhile the thickness were respectively (2.05 ± 0.20) mm, (1.91 ± 0.23) mm and (1.84 ± 0.25) mm. The value of width and thickness of the adjacent teeth gingiva were (3.19 ± 0.42) mm and (1.96 ± 0.23) mm respectively. No significant differences were found between transferred tissue and adjacent teeth gingiva on width and thickness (P＞0.05). Observation results of GI and positive rate of BOP of transferred tissue were also similar to which of gingiva of the adjacent teeth.

Technique of apically positioned flap is an effective measure on buccal keratinized gingiva reconstruction.