Evaluation of keratinized gingiva changes with buccal-based modified palatal flap in anterior maxillary implants

Background. Studies have shown a significant relationship between the width and thickness of keratinized gingiva around the implant and changes in marginal bone level, with a significant effect on the health and esthetic of tissues around the implant, especially in the anterior region of the maxilla, which is an esthetic area.

Methods. Ten patients referring to the Faculty of Dentistry seeking implant placement in the anterior maxilla were included in the study. The connective tissue of the palatal gingiva of the surgical site was folded to the buccal aspect with the buccal base, and the thickness and width of keratinized gingiva around the buccal surface of each implant were measured in three time intervals, including before surgery and 6 and 12 weeks after surgery. Based on the results of the Kolmogorov-Smirnov test, Friedman test and repeated-measures ANOVA were used to analyze the data.

Results. The intervention significantly affected changes in the gingival thickness. After the intervention, gingival thickness significantly increased compared to the baseline (P<0.05). The results also showed that the intervention did not significantly affect the width of keratinized gingiva. The width of keratinized gingiva at baseline was not significantly different from the two time intervals after intervention (P>0.05).

Conclusion. Buccal-based modified palatal flap in anterior maxillary implants increased the thickness of keratinized gingiva, with no significant effect on the keratinized gingiva width.