Periodontal Soft Tissue Non-Root Coverage Procedures: Practical Applications From the AAP Regeneration Workshop

Area of Science:

• Periodontology
• Oral Surgery

Background:

• Suboptimal plaque control and inflammation can cause attachment loss and gingival recession (GR).
• A minimum amount of keratinized tissue (KT) and attached gingiva is essential for gingival margin stability.
• Mucogingival deformities require gingival augmentation for both functional and esthetic improvement.

Purpose of the Study:

• To review indications and clinical applications of gingival augmentation procedures.
• To identify factors guiding the selection of treatment options for specific patient situations.
• To summarize evidence supporting treatment decisions in mucogingival surgery.

Main Methods:

• Review of prospective and retrospective studies on gingival augmentation.
• Analysis of various grafting techniques, including free gingival grafts (FGGs) and alternatives.
• Consideration of autogenous grafts and non-autogenous substitutes.

Main Results:

• Free gingival grafts (FGGs) are a gold standard for root coverage in GR defects.
• Gingival augmentation of KT and attached gingiva can be achieved through FGGs or other autogenous grafts.
• Alternatives include acellular dermal matrix, extracellular matrix membrane, and bilayer collagen matrix.

Conclusions:

• Recognizing the importance of adequate attached gingiva is key for managing mucogingival conditions.
• Patient education on plaque control and smoking cessation significantly enhances surgical success.
• Tailoring surgical procedures based on patient-specific factors optimizes gingival tissue augmentation.