case_images: PMC6334554_01
case_images: (a) Vestibular and (b) occlusal view showing the small amount of keratinized gingiva
case_images: JISP-23-77-g001.jpg
case_images: PMC6334554_01_JISP-23-77-g001.jpg
case_images: F1
case_images: The absence of tooth 34 and marginal level of keratinized gingiva was observed [Figure 1].
case_images: Horizontal incision below the mucogingival line and the bony crest
case_images: JISP-23-77-g002.jpg
case_images: PMC6334554_01_JISP-23-77-g002.jpg
case_images: F2
case_images: A horizontal incision was made under the bony crest of the edentulous space just below the mucogingival line [Figure 2].
case_images: Vertical incision made in the mesial
case_images: JISP-23-77-g003.jpg
case_images: PMC6334554_01_JISP-23-77-g003.jpg
case_images: F3
case_images: Two vertical incisions of approximately 4 mm were made, one in the mesial [Figure 3] and one in the distal area [Figure 4] of the edentulous space.
case_images: Vertical incision was made in the distal
case_images: JISP-23-77-g004.jpg
case_images: PMC6334554_01_JISP-23-77-g004.jpg
case_images: F4
case_images: Two vertical incisions of approximately 4 mm were made, one in the mesial [Figure 3] and one in the distal area [Figure 4] of the edentulous space.
case_images: Papilla of teeth 33 and 36 preserved
case_images: JISP-23-77-g005.jpg
case_images: PMC6334554_01_JISP-23-77-g005.jpg
case_images: F5
case_images: The papilla was preserved [Figure 5].
case_images: A partial thickness flap was performed in the buccal region of the mandible
case_images: JISP-23-77-g006.jpg
case_images: PMC6334554_01_JISP-23-77-g006.jpg
case_images: F6
case_images: A partial thickness, 5 mm flap was made on the vestibular mucosa [Figure 6].
case_images: Harvesting graft from the palate
case_images: JISP-23-77-g007.jpg
case_images: PMC6334554_01_JISP-23-77-g007.jpg
case_images: F7
case_images: The free gingival graft was removed from the palate region between 2.0 mm-3.0 mm thickness and 30.0 mm of length [Figure 7].
case_images: Removal of the epithelium tissue from part of the free gingival graft with the aid of a 15C scalpel blade
case_images: JISP-23-77-g008.jpg
case_images: PMC6334554_01_JISP-23-77-g008.jpg
case_images: F8
case_images: Before placement in the recipient bed, one part of graft was cascaded (epithelial tissue was removed) [Figure 8] is the modification of the classical technique of free gingival grafting.
case_images: (a) Suture starting in the lingual mucosa, passing through the de- 9:epithelized graft and returning to the lingual mucosa, the graft is tractioned by the suture under the mucosa of the osseous ridge; (b) part of the epithelized graft covers the partial thickness flap on buccal side
case_images: JISP-23-77-g009.jpg
case_images: PMC6334554_01_JISP-23-77-g009.jpg
case_images: F9
case_images: The bony crest portion of the deepithelialized graft was enveloped with the aid of a horizontal mattress suture under the flap [Figure 9].
case_images: (a) A compression suture and (b) two simple mesial and distal sutures were made for the graft stabilization
case_images: JISP-23-77-g010.jpg
case_images: PMC6334554_01_JISP-23-77-g010.jpg
case_images: F10
case_images: Compression sutures were made to stabilize the graft on the vestibular region of mandible [Figure 10].
case_images: Occlusal view of the keratinized gingiva thickness (a) before the surgical procedure and (b) after 90 days
case_images: JISP-23-77-g011.jpg
case_images: PMC6334554_01_JISP-23-77-g011.jpg
case_images: F11
case_images: After 90 days, an increase, in keratinized tissue was observed both horizontally and vertically, making the site more suitable to receive the dental implant [Figure 11].
case_images: After 90 days, a vertical increase of the gingiva was observed after implant installation
case_images: JISP-23-77-g012.jpg
case_images: PMC6334554_01_JISP-23-77-g012.jpg
case_images: F12
case_images: A new gingival measurement was performed using a millimeter probe during installation of the implant, more than 3.0 mm of keratinized mucosa height was observed [Figure 12].
case_images: Thickness and height of the keratinized tissue remained unchanged after installed healing cap
case_images: JISP-23-77-g013.jpg
case_images: PMC6334554_01_JISP-23-77-g013.jpg
case_images: F13
case_images: The implant was installed with the healing cap, and the patient was instructed to return for a follow-up appointment after 30 days, and it was observed that the thickness and height of the keratinized tissue remained unchanged [Figure 13].