Peri-implant Buccal and Lingual Keratinized Mucosa Augmentation Following Bone Reconstruction

Large bone reconstruction often results in distortion of the position of the MGJ and limited residual keratinized mucosa (KM) width at the future implant(s) site. It is well known that an adequate band of KM plays a positive role on peri-implant health and tissue stability. Therefore, surgical techniques designed to reconstruct sufficient peri-implant soft tissue-not only on the buccal aspect but circumferentially around the implant-are highly recommended/advocated. The present manuscript depicts 4 variations of the strip gingival graft technique designed to achieve an adequate width of peri-implant KM and sufficient mucosal thickness (MT) following large bone reconstruction and implant placement at mandibular sites. The rationale for these surgical approaches over conventional techniques, along with anatomical, clinical, and patient-centered considerations related to augmentative procedures, is discussed.