The partly epithelialized free gingival graft (pe-fgg) at lower incisors. A pilot study with implications for alignment of the mucogingival junction

Aims A partly epithelialized free gingival graft (PE-FGG) is described for the treatment of isolated and multiple gingival recessions in lower incisors to improve root coverage potential and mucogingival junction (MGJ) alignment. Methods Twelve single gingival recessions in 12 patients and 16 multiple recessions in 7 patients at lower incisors were included. A FGG partly deprived of epithelium was harvested from the palate. The epithelialized coronal part of the graft extended from the CEJ to the ideal position of the MGJ of the recession site/s. The apical part of the PE-FGG deprived of the epithelium was inserted between the alveolar mucosal flap and the recipient bed periostium. An aesthetic evaluation was performed. Results Treatment resulted in 94 `+/- 11% and 96 +/- 11% root coverage and 75% and 87.5% of the treated teeth completely covered in the single recession and in the multiple recession groups respectively. The 1-year KT was associated with the baseline extent of the epithelialized part of the graft in both groups. As a consequence, the MGJ resulted in properly aligned teeth in 14 of 19 patients. Three independent clinicians assigned an aesthetic score ranging from 6.36 +/- 2.5 to 7.91 +/- 1.7 in the single REC group and from 6.62 +/- 2.2 to 7.87 +/- 1.8 in the multiple REC group. Conclusions The application of the M-FGG resulted in high percentage of recessions completely covered with excellent alignment of the MGJ and appreciable aesthetic outcomes.