FREE GINGIVAL GRAFT MORPHOGENESIS

Abstract


This review analyzes the current state of the problem of creating the area of keratinized and attached gingiva in dental implantology. Apically positioned flap with a free gingival graft (FGG) placement is considered the gold standard in the oral soft tissue plastic surgery. It is noted that the periosteal or connective tissue recipient bed is an important prerequisite to graft revascularization and survival. FGGs placed on the periosteum often display clinical mobility while grafts fixed on denuded alveolar bone predictably create a firmly attached band of keratinized gingiva. The development of specific techniques and methods for fixing the FGG on bone bed have special priority. Exploring rigid fixation of the graft, as well as cellular and molecular mechanisms that determine the dynamics of the regenerative processes at the graft-bed interface has great clinical potential.


Full Text

Restricted Access

About the authors

S. S Edranov

Department of histology Pacific State Medical University of the Ministry of Public Health of the Russian Federation

Author for correspondence.
Email: info@eco-vector.com
690002, Vladivostok, Russia

R. A Kerzikov

Department of histology Pacific State Medical University of the Ministry of Public Health of the Russian Federation

Email: r.kerzikov@gmail.com
690002, Vladivostok, Russia

References

  1. Калиниченко С.Г., Матвеева Н.Ю., Костив Р.Е., Пузь А.В. Сосудистый эндотелиальный фактор роста и трансформирующий фактор роста-b2 в костной ткани крыс при установке после перелома титановых имплантатов с биоактивными биорезорбируемыми покрытиями. Бюллетень экспериментальной биологии и медицины. 2016; 162 (11): 626-31.
  2. Плехова Н.Г., Ляпун И.Н., Калиниченко С.Г., Матвеева Н.Ю., Костив Р.Е., Гнеденков С.В. и др. Влияние биоинертных и биорезорбируемых металлических имплантатов на экспрессию мембранных рецепторов дендритных клеток. Современные проблемы науки и образования. 2015; 5: 181-4.
  3. Матвеева Н.Ю., Костив Р.Е., Калиниченко С.Г., Пузь А.В., Плехова Н.Г. Динамика регенерации перелома бедренной кости крыс с применением титанового имплантата с поверхностно активным покрытием. Международный журнал прикладных и фундаментальных исследований. 2015; 10 (5): 849-53.
  4. Karring T., Östergaard E., Löe H. Conservation of tissue specifically after heterotopic transplantation of gingiva and alveolar mucosa. J. Periodontal Res. 1971; 6 (4): 282-93.
  5. Kim S.S. et al. Regulation of matrix remodelling phenotype in gingival fibroblasts by substratum topography. J. Cell. Mol. Med. 2015; 19 (6): 1183-96.
  6. Berglundh T., Lindhe J., Ericsson I., Marinello C.P., Liljenberg B., Thomsen P. The soft tissue barrier at implants and teeth. Clin. Oral Implants Res. 1991; 2 (2): 81-90.
  7. Wennström J.L., Derks J. Is there a need for keratinized mucosa around implants to maintain health and tissue stability? Clin. Oral Implants Res. 2012; 23 (Suppl. 6): 136-46.
  8. Brito C., Tenenbaum H.C., Wong B.K.C., Schmitt C., Nogueira-Filho G. Is keratinized mucosa indispensable to maintain peri-implant health? A systematic review of the literature. J. Biomed. Mater. Res. Part B Appl. Biomater. 2014; 102 (3): 643-50.
  9. Ladwein C., Schmelzeisen R., Nelson K., Fluegge T.V., Fretwurst T. Is the presence of keratinized mucosa associated with periimplant tissue health? A clinical cross-sectional analysis. Int. J. Implant Dent. 2015; 1 (1): 1.
  10. Roccuzzo M., Grasso G., Dalmasso P. Keratinized mucosa around implants in partially edentulous posterior mandible: 10-year results of a prospective comparative study. Clin. Oral Impl. Res. 2016; 27 (4): 491-6.
  11. Sevor J.J. The use of free gingival grafts to improve the implant soft tissue interface: rationale and technique. Pract. Periodontics Aesthet. Dent.: PPAD. 1992; 4 (9): 59-64.
  12. Crespi R., Cappare P., Gherlone E. A 4-year evaluation of the peri-implant parameters of immediately loaded implants placed in fresh extraction sockets. J. Periodontol. 2010; 81 (11): 1629-34.
  13. Lin G.H., Chan H.L., Wang H.L. The significance of keratinized mucosa on implant health: a systematic review. J. Periodontol. 2013; 84 (12): 1755-67.
  14. Souza A. B., Tormena M., Matarazzo F., Araújo M. G. The influence of peri-implant keratinized mucosa on brushing discomfort and peri-implant tissue health. Clin. Oral lmpl. Res. 2016; 27 (6): 650-5.
  15. Bengazi F., Wennstrom J.L., Lekholm U. Recession of the soft tissue margin at oral implants. A 2-year longitudinal prospective study. Clin. Oral lmpl. Res. 1996; 7 (4): 303-10.
  16. Zigdon H., Machtei E.E. The dimensions of keratinized mucosa around implants affect clinical and immunological parameters. Clin. Oral Impl. Res. 2008; 19 (4): 387-92.
  17. Rapley J.W., Mills P.M., Wylam J. Soft tissue management during implant maintenance. Int. J. Perio. & Res. Dent. 1992; 12 (5): 373-81.
  18. Linkevicius T., Apse P., Grybauskas S., Puisys A. The influence of soft tissue thickness on crestal bone changes around implants: a 1-year prospective controlled clinical trial. Int. J. Oral Maxillofac. Impl. 2009; 24 (4): 712-9.
  19. Bengazi F., Botticelli D., Favero V., Perini A., Urbizo Velez J., Lang N.P. Influence of presence or absence of keratinized mucosa on the alveolar bony crest level as it relates to different buccal marginal bone thicknesses. An experimental study in dogs. Clin. Oral lmpl. Res. 2014; 25 (9): 1065-71.
  20. Puisys A., Linkevicius T. The influence of mucosal tissue thickening on crestal bone stability around bone-level implants. A prospective controlled clinical trial. Clin. Oral lmpl. Res. 2015; 26 (2): 123-29.
  21. Bengazi F., Lang N. P., Caroprese M., Urbizo Velez J., Favero V., Botticelli D. Dimensional changes in soft tissues around dental implants following free gingival grafting: an experimental study in dogs. Clin. Oral lmpl. Res. 2015; 26 (2): 176-82.
  22. Warrer K., Buser D., Lang N.P., Karring T. Plaque-induced peri-implantitis in the presence or absence of keratinized mucosa. An experimental study in monkeys. Clin. Oral Impl. Res. 1995; 6 (3): 131-8.
  23. Monje A., Galindo-Moreno P., Tözürm T.F., Suárez-López del Amo F., Wang, H.L. Into the paradigm of local factors as contributors for peri-implant disease: a short communication Int. J. Oral Maxillofac. Impl. 2016; 31 (2): 288-92.
  24. Jung R.E., Sailer I., Hammerle C.H.F., Attin T., Schmidlin P., Dent P.D.M. In vitro color changes of soft tissues caused by restorative materials. Int. J. Periodontics Restor. Dent. 2007; 27 (3): 251-7.
  25. Dordick B., Coslet J.G., Seibert J.S. Clinical evaluation of free autogenous gingival grafts placed on alveolar bone: Part I. Clinical predictability. J. periodontol. 1976; 47 (10): 559-67.
  26. Nanci A., Ten Cate A.R. Ten Cate’s Oral histology: development, structure, and function. 8th Ed. St. Louis: Mosby Elsevier; 2013.
  27. Mackenzie I.C., Hill M.W. Connective tissue influences on patterns of epithelial architecture and keratinization in skin and oral mucosa of the adult mouse. Cell and tissue res. 1984; 235 (3): 551-9.
  28. Hill M.W., Mackenzie I.C. The influence of differing connective tissue substrates on the maintenance of adult stratified squamous epithelia. Cell and tissue res. 1984; 237 (3): 473-8.
  29. Okazaki M., Yoshimura K., Suzuki Y., Harii K. Effects of subepithelial fibroblasts on epithelial differentiation in human skin and oral mucosa: heterotypically recombined organotypic culture model. Plast. and reconstr. surg. 2003; 112 (3): 784-92.
  30. Karring T., Lang N.P., Loe H. The role of gingival connective tissue in determining epithelial differentiation. J. Periodontal Res. 1975; 10 (1): 1-11.
  31. Bassetti R.G., Stähli A., Bassetti M.A., Sculean A. Soft tissue augmentation procedures at second-stage surgery: a systematic review. Clin. oral investigations. 2016; 1-19.
  32. Matouk M., Sclar A.G. Oral connective tissue grafting: evidence-based principles for predictable success. Oral Maxillofac. Surg. Clin. North Am. 2002; 14 (2): 241-57.
  33. Kim D.M., Neiva R. Periodontal soft tissue non-root coverage procedures: a systematic review from the AAP regeneration workshop. J. periodontol. 2015; 86 (2-s): S56-S72.
  34. Oliver R.C., Löe H., Karring T. Microscopic evaluation of the healing and revascularization of free gingival grafts. J. Periodontal Res. 1968; 3 (2): 84-95.
  35. Janson W.A., Ruben M.P., Kramer G.M., Bloom A.A., Turner H. Development of the blood supply to split-thickness free gingival autografts. J. Periodontol. 1969; 40 (12): 707-16.
  36. Guiha R., el Khodeiry S., Mota L., Caffesse R. Histological evaluation of healing and revascularization of the subepithelial connective tissue graft. J. Periodontol. 2001; 72 (4): 470-8.
  37. Camargo P.M., Melnick P.R., Kenney E.B. The use of free gingival grafts for aesthetic purposes. Periodontol. 2000. 2001; 27 (27): 72-96.
  38. Nobuto T., Imai H., Yamaoka A. Microvascularization of the free gingival autograft. J. Periodontol. 1988; 59 (10): 639-46.
  39. Wullstein, H., Wullstein, S. The altered metabolism of the full thickness skin graft. The Laryngoscope. 1972; 82 (11): 1990-9.
  40. Caffesse R.G., Burgett F.G., Nasjleti C.E., Castelli W.A. Healing of Free Gingival Grafts With and Without Periosteum. Part I. Histologic Evaluation. J. Periodontol. 1979; 50 (11): 586-94.
  41. James W.C., McFall W.T. Placement of free gingival grafts on denuded alveolar bone. Part I: clinical evaluations. J. Periodontol. 1978; 49 (6): 283-90.
  42. Belem Novaes A., Belem Novaes Jr. A. Superficial bone resorption: a negative or positive factor in wound healing? Int. J. Periodontics Restor. Dent. 1996; 16 (1): 78-87.
  43. Jee W.S. Integrated bone tissue physiology: anatomy and physiology. In: Cowin S.C., ed. Bone mechanics handbook. Boca Raton: CRC Press; 2001: 1-68.
  44. Едранов С.С. Роль оксида азота в повреждении и репарации слизистой оболочки верхнечелюстной пазухи. Российский стоматологический журнал. 2012; 6: 38-42
  45. Едранов С.С. Посттравматический гайморит: вопросы патогенеза. Экспериментальное и клиническое исследования. Владивосток: Медицина ДВ; 2013.
  46. Едранов С.С. Клеточно-молекулярные аспекты посттравматической регенерации слизистой оболочки околоносовых пазух. Тихоокеанский медицинский журнал. 2016; 2 (64): 67-71.
  47. Bissada N.F., Sears S.B. Quantitative assessment of free gingival grafts with and without periosteum and osseous perforation. J. Periodontol. 1978; 49 (1): 15-20.
  48. Mörmann W., Schaer F., Firestone A.R. The relationship between success of free gingival grafts and transplant thickness. Revascularization and shrinkage - a one year clinical study. J. Periodontol. 1981; 52 (2): 74-80.
  49. Nawa Y. Experimental study of free gingival grafts. A comparative reference of the periosteal bed and the denuded bone bed. J. Japan Societ. Periodontolog. 1988; 30 (1): 99. (in Japanese)
  50. Yanagihara K. Experimental studies on morphological changes of microvascular architecture following the free gingival autograft on denuded alveolar bone. J. Japan. Societ. Periodontolog. 1990; 32 (1): 45-70. (in Japanese)
  51. Tamaki O. Tissue from repair the aspect after free gingival graft with and without of the periosteum periodontium of destruction and regeneration. J. Japan. Societ. Periodontol. 1991; 33 (4): 824-39. (in Japanese)
  52. Imai H., Yanagihara K., Nobuto T., Ri S., Hiromi T., Yamaoka A. Morphological changes in the microvascular architecture of the vascular plexus of the periosteum following the free gingival autograft on denuded alveolar bone. J. Japan. Societ. Periodontol. 1994; 36 (3): 599-611.
  53. Thoma D.S., Benić G.I., Zwahlen M., Hämmerle C.H., Jung R.E. A systematic review assessing soft tissue augmentation techniques. Clin. Oral Impl. Res. 2009; 20 (s4): 146-65.
  54. Barbosa M.D., Gregh S.L.A., Passanezi E. Fibrin adhesive derived from snake venom in periodontal surgery. J. periodontol. 2007; 78 (10): 2026-31.
  55. Barbosa F.I., Corrêa D.S., Zenóbio E.G., Costa F O., Shibli J.A. Dimensional changes between free gingival grafts fixed with ethyl cyanoacrylate and silk sutures. J. Int. Acad. Periodontol. 2009; 11 (2): 170-6.
  56. Hassani A., Sadrimanesh R., Vahdati S.A., Sadr-eshkevari P. Free gingival graft immobilization: a pilot study on a newly designed stent. J. Oral Impl. 2010; 36 (2): 123-30.
  57. Merli M. Implant therapy: the integrated treatment plan. Milan: Quintessenza edizioni; 2012; 1.

Statistics

Views

Abstract - 35

PDF (Russian) - 0

Cited-By


Article Metrics

Metrics Loading ...

Refbacks

  • There are currently no refbacks.

Copyright (c) 2017 Eco-Vector



This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies