Fibrin immobilization vestibular extension (FIVE): A case series

Area of Science:

• Periodontology
• Oral Surgery
• Regenerative Dentistry

Background:

• Peri-implant mucosal phenotype modification is crucial for long-term implant success.
• Existing techniques for increasing keratinized mucosa width can be invasive, requiring autogenous grafts.

Observation:

• The fibrin immobilization vestibular extension (FIVE) protocol was applied to 30 patients with 93 implants for various indications.
• Preoperative keratinized mucosal width averaged 1.67 mm, significantly increasing to 9.10 mm immediately post-surgery.
• At 3 months, a stable width of 4.9 mm was observed, maintained at 4.0 mm by 3 years.

Findings:

• The FIVE protocol demonstrated significant vestibular extension and increased keratinized mucosal width.
• Maxillary sites showed a greater mean width (6.1 mm) compared to mandibular sites (5.1 mm) (p < 0.0001).
• In peri-implantitis cases, the protocol led to significant pocket reduction and wide keratinized mucosa, though 7 implants were lost due to advanced disease.

Implications:

• The FIVE protocol offers a viable alternative to autogenous grafts for peri-implant mucosal augmentation.
• This technique shows promise for improving esthetics and function in implant dentistry.
• Further research can explore long-term outcomes and refine the protocol for specific clinical scenarios.