Efficacy of free gingival graft in treatment of localized gingival recession in smokers and non-smokers: donor site healing, graft shrinkage and success

Abstract

Objective: The objective of this study was designed to evaluate the effect of light smoking (≤10 cigarettes per day) and number of years of cigarettes smoking on free gingival graft procedures. Subjects and Methods: A total of 22 patients with miller class I,II gingival recession consist of two group: group I was 12 non-smokers and group II 10 smokers(≤10 cigarettes per day & less than five years on smoking habit). All patients were treated with free gingival graft. Phase I therapy was performed for all patients to provide an oral environmental more favorable to wound healing. The following clinical indices measurements of plaque index, gingival index, probing depth clinical attachment level, recession height, recession width, width of keratinized gingiva, gingival thickness, graft shrinkage (length, width),immediate and delayed bleeding, complete epithelization and discomfort, sensibility disorder all were recorded at 1 month,3 months and 6months. Results: The non smokers group showed significant decrease of recession width and graft shrinkage area compared to smokers group. The clinical parameters showed improvement in nonsmoker group more than smokers group but the difference was not statistically significant. Probing depth, clinical attachment level, recession height, keratinzation tissue width, gingival thickness, the improvement occurs at all follow up periods was more in non smokers than smokers but the difference was not statistically significant. Regarding donor site healing bleeding was more in non smoker, pain was more in smokers group and complete epithelization was equal and the difference between both groups wasn’t significant. Conclusion: Following free gingival graft procedures, free gingival graft undergoes graft shrinkage which decrease amount root coverage. Light and young smokers showed increased in recession width and graft shrinkage area. KEYWORDS: gingival recession, graft, smoking