[Application of attached gingiva reconstruction in implant-supported dental prosthesis]

To explore a method of attached gingiva reconstruction around dental implants and to evaluate its clinical outcomes and technical characters.

From January 2011 to August 2011, a total of 10 implants were included in this study from 8 patients who had inadequate attached gingiva and needed to undergo secondary operation. A modified apically positioned flap technique was applied to reconstruct attached gingiva at the time of secondary operation. Crown restoration was finished 4 weeks after the operation and the patients were recalled 6 months after restoration. Effective keratinized mucosal width was recorded separately before the operation, 4 weeks after the operation and 6 months after restoration. Clinical examination was conducted 6 months after restoration including modified plaque index(mPI), probing depth(PD), bleeding index(BI) and percentage of bleeding on probing. Statistical analysis was performed using Wilcoxon signed rank test with SPSS18.0 software package.

Four weeks after the operation, there was an average increase of 2.41 mm in effective keratinized mucosal width compared with the preoperative value (P<0.05). After 6 months of function, the newly formed keratinized mucosa remained stable and attached to the crown tightly without obvious inflammation. The mean width was (2.64±0.53) mm. Clinical examinations showed a mean mPI of 0.70±0.82, a mean PD of (1.80±0.36) mm, and a mean BI of 0.73±0.64. In terms of bleeding on probing, 23.3% of sites showed positive outcome.

By using the modified apically positioned flap technique at the time of secondary operation, the attached gingiva around implants can be effectively reconstructed. The short-term effects are satisfactory.