30 May 2024

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Novel Technique Offers Suture Alternative for Free Gingival Graft Procedure

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Dental implants are a widely used, common substitute for missing teeth to help maintain jaw alignment, oral health, and overall well-being; however, complications can still arise as dental implantation is considered major oral surgery. There are many steps dental practitioners must take to ensure a successful implant procedure, one of which is performing grafts to ensure the oral tissues, especially the keratinized mucosa (KM), are healthy, stable, and plentiful enough to sustain the implant. Without adequate KM width (KMW), the implant site is vulnerable to infection and inflammation that could prevent proper healing and ultimately cause implant failure.

Researchers from Wuhan University and private practice in Wuhan, China; Edong Healthcare Group in Huangshi, China; and the University of Toronto in Toronto, Ontario, Canada, recently published a study in the Journal of Oral Implantology to assess a novel technique for augmenting the KM and to help improve the time-consuming suturing stage of the free gingival graft (FGG) needed to support implantation. Given the complications that can arise during suturing, including postoperative pain and inflammation, and that suture-less techniques remain controversial, Anbin Xu, DDS, and colleagues state, “a novel ‘microscrew with tie-down sutures’ technique was proposed to stabilize FGG on the recipient site as an alternative to the traditional suturing method.” They hypothesized that “this technique can simplify the FGG surgical procedure, shorten surgery time, and enhance KM around the implant more effectively.”

Xu et al. present a case study of a 65-year-old woman with three missing teeth on the right side of her jaw. She had three implants placed approximately three months earlier. After three months, the healing cap on one tooth fell off and was loosening on another, indicating that the implant procedure was not succeeding as planned. The researchers also noted that the KMW was less than optimal, and debris built up around the healing caps.

The patient underwent additional oral surgery to increase the KMW by way of a FGG with an apically positioned flap. The FGG was closed using the novel “microscrew with tie-down sutures” method, and antibiotics were prescribed for two days. At 14 days post-surgery, the FGG showed no signs of infection and was healing well; all sutures were removed. At one month, healing was complete, and the implants were determined to be ready to be restored. The KM was stable and healthy one year after restoration, and the implantation was successful.

The success of this novel procedure offers a new avenue for suturing after an FGG procedure that could lessen surgery time and increase overall KMW. Xu and colleagues conclude, “The ‘microscrew with tie-down sutures’ technique presents a feasible, simplified, and problem-solving resolution for enhancing KM around the implant in the posterior area. Future studies on this technique should include additional cases and longer tracking times.”

Full text of the article, “A Novel ‘Microscrew With Tie-Down Sutures’ Technique for FGG Anchorage: A Case Report,” Journal of Oral Implantology, Vol. 50, No. 2, 2023, is available at https://meridian.allenpress.com/joi/article/50/2/75/500533/A-Novel-Microscrew-With-Tie-Down-Sutures-Technique.

About Journal of Oral Implantology

The Journal of Oral Implantology is the official publication of the American Academy of Implant Dentistry and the American Academy of Implant Prosthodontics. It is dedicated to providing valuable information to general dentists, oral surgeons, prosthodontists, periodontists, scientists, clinicians, laboratory owners and technicians, manufacturers, and educators. The JOI distinguishes itself as the first and oldest journal in the world devoted exclusively to implant dentistry.

Source: http://www.joionline.org/orimonline/?request=index-html