Management of peri-implant mucositis of multiple osseointegrated implants using a modified free gingival graft 'Punch technique' in the total edentulous area: A case report

The purpose of this case report was to describe a technique to modify the free gingival graft by perforations within the graft to guarantee a horizontal increase in the keratinized mucosa in the anteroinferior sector of a total edentulous mandible after osseointegration of previously placed dental implants in a hybrid prosthesis protocol. A 71-year-old male underwent free modified gingival graft surgery with perforations at the level of each implant. At 3 months, the mucosa appeared to be healthy and keratinized, especially at a horizontal level around the implants previously diagnosed with mucositis, providing the patient with satisfactory results. Finally, the hybrid prosthesis was cleaned and polished due to the presentation of a hard plate at the level of the abutments. Within the limitations of this case report, further research is needed to evaluate the long-Term efficacy of this modification to the free gingival graft.