Evaluation of Free Gingival Graft Timing

Inclusion Criteria

• • At least 18 years old

• No uncontrolled medical conditions or medications that will affect their bone healing.
• Good oral hygiene is defined as a full-mouth plaque score ≤25%11.
• Must be able to read and understand the informed consent document.
• Has a need for implants to replace missing tooth/teeth in at least 1 quadrant of the mouth.
• Insufficient alveolar ridge width for endosseous implant placement, defined as 5 mm or less, as determined by bone sounding and CBCT scan.
• The patient and/or guardian is willing and able to comply with pre-operative and post-operative diagnostic and clinical evaluations required.
• The patient is not pregnant or breastfeeding.

Exclusion Criteria

• Active infectious diseases.

• Liver or kidney dysfunction/failure.
• Uncontrolled diabetes (HbA1c ≥ 8.5).
• Active cancer treatment - such as active chemotherapy radiation therapy, or radiotherapy performed within ≤12 months from the procedure.
• Taking medications that will affect their bone healing (for example, bisphosphonates and long-term anti-inflammatory medications).
• Metabolic bone diseases that affect bone healing such as osteoporosis.
• Pregnant or lactating women (self-reported).
• Current tobacco and Marijuana smokers have 10 or more cigarettes per day, and former smokers (\> 10 cigarettes) who quit \< 10 ago (self-reported).
• Poor oral hygiene.
• Vertical loss of bone at the edentulous ridge.
• History of periodontal disease.
• The patient is pregnant or breastfeeding