Comparison of conventional and modified sling suture techniques in FGG operations with cairo type 2 and type 3 localized gingival recessions

The aim of this study is to investigate the effects of conventional suture (CS) and modified sling suture (MSS) techniques, applied in free gingival graft (FGG) operations using gingival unit graft (GUG) and conventional graft (CG) techniques, on clinical parameters and graft sizes. 52 individuals having CAIRO Type 2 (RT2) and Type 3 (RT3) gingival recessions in their mandibula anterior region were divided into four groups as a) GUG+MSS (n=13), b) GUG+CS (n=13), c) CG+MSS (n=13) and d) CG+CS (n=13). Keratinized gingival width (KGW), keratinized gingival thickness (KGT), relative gingival recession height (rGRH), and relative vestibule depth (rVD) measurements were recorded using a digital caliper and UNC 15 periodontal probe. Dimensional changes of the graft was determined by measuring the surface area (GSA) of the graft during the healing period using ImageJ software. All measurements were repeated at baseline, 1st and 3rd months. It was determined that the increase in KGW in the 1st and 3rd month compared to the baseline in GUG+CS group was significantly higher than GUG+MSS group (p<0.05). Baseline KGT was significantly higher in the GUG+MSS group compared to the CG+MSS and CG+CS groups (p<0.05), on the other hand, the change (Δ) in the KGT levels in the evaluated time periods was not statistically significant between the groups (p>0.05). When ΔGSA (mm2) and ΔGSR (%) values were compared between the groups, it was determined that the amount of decrease in the 1st and 3rd month compared to baseline in the KG+MAS group was found to be significantly higher than the GUG+MSS and GUG+CS groups (p< 0.05). ΔrGRH and ΔrVD measurements were not different between groups (p>0.05). Within the limits of this study, it can be concluded that keratinized gingiva can be obtained successfully either with GUG or CG techniques in FGG operations, on the other hand, regardless of the suture technique used, the graft obtained with the GUG technique showed less dimensional graft shrinkage. Keywords: Free gingival graft, Gingival unit graft, Modified sling suture, Shirinkage