Modified approach for keratinized tissue augmentation in multiple teeth

This case report demonstrated a modified technique of free gingival graft (FGG) aiming to increase keratinized attached tissue in large recipient areas. A FGG to increase the amount of attached gingival tissue, facilitate oral hygiene, and prevent further clinical attachment loss was realized in two patients. Because the extensive recipient area, a modified technique was performed to obtain a smaller graft of the donor area. A template of the graft was made about 25%–30% smaller than the total recipient area. After graft removal, interspersed incisions were made in the upper and lower edges of it. After 9–24 months of follow-up, the final width of the keratinized tissue was 4.0–4.4 times larger in comparison to initial clinical condition. In conclusion, this FGG technique can be considered an alternative to gain sufficient amount of keratinized gingival tissue using a smaller graft.