Creeping attachment following free gingival grafts around dental implants exhibiting mucosal recession with a lack of keratinised mucosa: A case series

Purpose: Few case reports have been published on creeping attachment around dental implants. This study aimed to assess changes in the level of the mucosal margin following placement of free gingival grafts around single implants exhibiting mucosal recession with < 2 mm keratinised mucosa compared to that of implants with >= 2 mm keratinised mucosa. Materials and methods: A total of 12 subjects with one or more implants were included. Nineteen implants displaying implant thread and/or prosthetic abutment exposure with < 2 mm keratinised mucosa were treated using free gingival grafts (FGG group), and 11 implants exhibiting >= 2 mm keratinised mucosa did not receive free gingival grafts (control group). The width of keratinised mucosa and the amount of mucosal recession were measured by a blind evaluator (MC). Results: A continual reduction in mucosal recession was observed at the 6- and 12-month followups in all except two of the FGG group implants, while no change in the level of the mucosal margin was observed in the control group. This postoperative coronal migration of the mucosal margin resulted in a 0.7-mm mean reduction in mucosal recession after 12 months in the FGG group. Conclusion: The level of the mucosal margin around implants exhibiting mucosal recession along with a lack of keratinised mucosa migrated coronally following free gingival grafts, and creeping attachment was observed in a number of patients.