Abstract
Aim
To compare clinical and histological keratinized tissue formation around teeth and implants following coronal repositioning of alveolar mucosa with or without a connective tissue graft.
Methods
In 9 beagle dogs, the third and fourth premolars (P3, P4) were extracted from one side of the maxilla. Three months after the tooth extraction, a full-thickness buccal flap was raised and 2 implants were placed in those healed areas. On the contralateral side, a buccal flap was also raised at the P3, P4 area. Before suturing, the dogs were randomly assigned to 3 study groups (control, non-keratinized tissue [NKT], and non-keratinized tissue connective tissue graft [NKT-CTG]). In the control group, the buccal flaps were repositioned around the teeth (P3, P4) on one side, and implants on the other side, presenting an adequate band of keratinized tissue (KT). For the NKT and NKT-CTG groups, this buccal KT was then excised. In the NKT group, the buccal flap without KT (alveolar mucosa) was repositioned around the teeth and implants. In the NKT-CTG group, a connective tissue graft taken from the excised KT was sutured to the buccal alveolar mucosa and then both were repositioned around the teeth and implants. The clinical height of the KT was measured at baseline and at 1, 2, and 3 months of healing. The animals were sacrificed at 3 months, at which point the KT height was measured histologically.
Results
The control group presented normal healing with a band of KT surrounding the teeth and implants. In the NKT and NKT-CTG groups, a new KT band approximately 2 mm in height (measured clinically and histologically) spontaneously formed around all teeth, regardless of whether a connective tissue graft had been placed. In the NKT implant group, no new KT was observed (clinically or histologically). Around the implants in the NKT-CTG group, a small amount of KT was formed in just 2 of the 6 implants.
Conclusion
After surgical excision of KT, spontaneous KT is formed around teeth but not around implants, regardless of the placement of a connective tissue graft.
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