Abstract: PURPOSE: To explore the reconstruction method of buccal keratinized gingiva around implant in posterior maxillary area, and to evaluate its clinical effects and periodontal condition around the implants. METHODS: A total of 11 implants were selected by screening from 11 patients who had inadequate keratinized gingiva and needed to undergo secondary operation. An optimized root directional flap technique was applied to reconstruct keratinized gingiva in the stage of secondary operation. Crown restoration was finished 6 weeks after surgery and the patients were recalled 3 months after dental restoration. Effective keratinized mucosal width was recorded separately before the operation, crown restoration and 3 months after restoration. Clinical periodontal examination was conducted 3 months after restoration including probing depth (PD), bleeding on probing (BOP) and periapical film. SPSS19.0 software package was used for paired t test. RESULTS: The average keratinized mucosal width was (1.44±0.34) mm and (3.30±0.36) mm before operation and after crown restoration, respectively.There was an average increase of 1.86 mm in effective keratinized mucosal width compared with preoperative value (P<0.05). Three months after restoration, the newly health keratinized gingiva remained stable without obvious inflammation. The mean width was (3.34±0.33) mm (P=0.58). Clinical periodontal examinations showed a mean PD of 2.83±1.20 and the mean BOP of 18.2%. CONCLUSIONS: By using modified root directional flap technique in the secondary implant operation, the buccal keratinized gingiva around the implants can be effectively reconstructed. The short-term outcomes are satisfactory.

Key words: Keratinized gingival, Implant surgery, Modified root directional flap