COMPARATIVE ANALYSIS OF METHODS OF INCREASING KERATINIZED ATTACHED GINGIVA AROUND IMPLANTS

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Background and Aim. The lack of keratinized attached gingiva around the implans is a reason of mobility soft tissue, the pocket forming what may cause implant failure. The aim of study is improving the efficiency of surgical treatment patients with insufficient width of keratinized attached gingiva in the implant. Material and Methods. Our study included 58 patients, aged from 18 to 75 years, with insufficient width of keratinized attached gingiva in the implant, who had dental implantation surgery. Patients were divided into 3 groups by random sampling: apically positioned flap (group 1), free gingival graft (FGG) transplantation (group 2), collagen matrix (CM) transplantation (group 3). The number of patients by gender and age, was comparable in all groups. Results and Discussion. In postoperative period the increase of keratinized attached gingiva, the severity of pain, edema and hyperemia, the wound epithelisation were observed. The increase of keratinized attached gingiva was observed in patients from 1 group (2.0±0.3 mm), 2 group (4.8±0.3 mm), 3 group (3.0±0.3 mm). Retraction of FGG was 31%; CM - 42% from initial on 28 day post. op. The largest edema and hyperemia were in patients with CM. The most painful post operative period fived in patient with FGG. The period of wound epithelisation in patients from 1 group (13.75±0.65), 2 group (12.5±0.6 mm), 3 group (16.8±0.7 mm). Morphological study of biopsies gingival mucosa after different plastic operations showed that all methods of plastics cause regeneration of stratified squamous keratinized epithelium and subepithelial mucosal own lamina. Conclusions. Surgical techniques increasing keratinized attached gingiva improve the effectiveness of patient care. The use of collagen matrix can be recommended as a method of choice to increase the width of keratinized attached gingiva.