Use of Free Gingival Graft and PRF to Increase the Width of the Attached Gingiva: A Novel Approach

Abstract

Inadequate width of attached gingiva can lead to difficulty in maintaining oral hygiene, can cause recession and if the patient is undergoing orthodontic treatment the bands and brackets might get engrossed in the buccal mucosa. Therefore, increasing the width of attached gingiva is necessary. A 19-year-old female patient who was referred from the Department of Orthodontics for impinging of bands into gingiva which was identified to be because of in adequate width of attached gingiva. Horizontal incision was given at mucogingival junction from 34 to 44 region. Full-thickness flap was raised till the required vestibular depth recipient site is required. Free Gingival Graft (FGG) of size 15×10 mm in size was harvested from left palatal mucosa from distal to 24 to mesial to 26 region. Harvested FGG was sutured from 32 to 42 region in the recipient site. Platelet Rich Fibrin (PRF) membrane was prepared using patients own blood and this membrane was sutured at 33 and 43 region at the recipient site. An aluminium foil was kept at the donor site and above the membrane at the recipient site on which periodontal pack was given. After 21 days of healing, the width of attached gingiva increased from 2 mm at baseline to 8 mm. According to visual analog scale, mild pain was felt by the patient and no difference in the colour was seen at both recipient and donor site at 21 days after surgery. Use of FGG and PRF helps to achieve improved results for increase width of attached gingiva.