Introduction: The presence of adequate keratinized mucosa (KM) around dental implants and natural
dentition is pivotal for the long-term success of dental restorations. Despite various techniques to
augment KM, challenges persist in achieving stable, keratinized, and adherent mucosa, especially in
the context of significant muscle pull or compromised tissue conditions. This study introduces a novel
application of titanium pins for the fixation of free gingival grafts (FGG) and apically repositioned
flaps (APF) during vestibuloplasty, aiming to overcome important limitations associated with
traditional suturing methods and shorten the treatment time and patient morbidity. Methods: Three
patients with insufficient KM width, presenting discomfort during oral hygiene and inflammation
around implant restorations and natural teeth, underwent soft tissue augmentation using titanium pins
traditionally used in guided bone regeneration (GBR) for the stabilization of FGGs and APFs. This
method ensures intimate contact between the graft and the periosteum, facilitating proper graft
perfusion and revascularization, minimizing shrinkage and the risk for necrosis of the graft. Results:
Postoperative follow-up revealed successful integration of the grafts, with minimal shrinkage and
increased width and depth of KM. The use of titanium pins allowed for reliable fixation in challenging
surgical sites, where traditional suturing methods were impractical due to the presence of extensive
muscle pull and an unstable recipient bed. Conclusion: The application of titanium pins for the fixation
of FGGs and APFs during vestibuloplasty provides a promising alternative to traditional suturing
techniques, particularly in complex cases where the recipient bed is suboptimal for suturing. This
method simplifies and shortens the procedure, offering a predictable outcome with increased
mechanical stability and minimal shrinkage of the graft. Randomized clinical trials are recommended
to further evaluate the efficacy of this technique.
Schlagwörter: Free Gingival Graft, Dental Implants , Apically repositioned flap, Titanium pins, Vestibuloplasty, Graft Survival, Periodontal Surgery, Titanium Pins, Transplants