Complications in the Use of Deepithelialized Free Gingival Graft vs. Connective Tissue Graft: A One-Year Randomized Clinical Trial

Int J Environ Res Public Health. 2021 Apr 23;18(9):4504. doi: 10.3390/ijerph18094504.

Abstract

In the treatment of gingival recession, different surgical options have been described: free gingival grafts (FGG), connective tissue Grafts (CTG), and a more recent technique, de-epithelialized free gingival graft (DFGG). They are not procedures exempt from the appearance of complications. Most publications refer to postoperative complications, and there is limited literature regarding the development of late complications (weeks or months). Our working group carried out a study to describe the development of late complications associated with the use of DFGG in comparison with CTG, providing an incidence rate and a classification. Sixty-eight patients with mucogingival problems were selected, and divided into two groups: the Test Group, for which we used DFGG + Coronal Advancement Flap (CAF), and the Control Group (CTG + CAF). All patients were treated at the University of Seville's dental school to solve mucogingival problems for aesthetic and/or functional reasons. A classification is proposed based on its severity; Major and Minor. Major complications included reepithelialization of the graft, epithelial bands, cul-de-sac, epithelial cysts, and bone exostoses. Minor complications included the graft´s color changes and superficial revascularization. Late major complications were only associated with the use of the DFGG, and the late minor complications developed with the use of the DFGG were much higher than those associated with CTG. CTG appears to be a safer procedure than DFGG in terms of late complications.

Keywords: Connective Tissue Grafts (CTG); De-Epithelialized Free Gingival Graft (DFGG); Free Gingival Grafts (FGG); bone exostoses; cul-de-sac; epithelial bands; epithelial cysts; late complications; reepithelialization; revascularization.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Connective Tissue
  • Follow-Up Studies
  • Gingiva*
  • Gingival Recession* / surgery
  • Humans
  • Tooth Root
  • Treatment Outcome