Titanium Tacks Assisted Soft Tissue Stabilization: A Novel Technique For Free Gingival Graft Fixation: (Clinical Case Series Study)

Aim:The purpose of this study is to evaluate the amount of free gingival graft contraction stabilized with titanium bone tacks in patients with deficient non-keratinized gingiva in the esthetic zone.Methods: This study is conducted on 10 patients with fifteen deficient non-esthetic keratinized gingiva, which hosted 15 free gingival graft secured with titanium tacks, the graft is photographed immediately after being fixed and after one, three and six months postoperatively.Using a software standardized surface area calibration of digital photographs, computation of the graft surface area is done and submitted to statistical analysis. Results:The tack fixation presumed less intraoperative time and provided firm, secure, and good stretch for all the grafts, which all healed uneventfully.After six months, the shrinkage rate counted (40.97% ± 2.55), with the highest estimate during the first month (27.64% ± 3.75).The mean shrinkage rate was recorded (18.31% ± 3.77) between one to six months, (11.36% ± 3.60) between three to six months, and (7.81% ± 2.98) between one to three months. Conclusion:Free gingival graft fixation with titanium tacks provides optimum graft fixation and spread, reduces intraoperative time and offers good clinical results; however, not statistically superior to the other techniques.The authors recommend modifying the design of the bone tacks to suit free gingival graft stabilization, where the underlying cortical plate is deficient.