الفهرس 
Titanium Tacks Assisseted Soft Tissue Stabilization: A Novel Technique For Free Gingival Graft Fixation (Case Series Study)
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Abstract
Aim: The aim of the study is clinical evaluation of the efficiency of the titanium tacks in free gingival graft fixation.
Methodology: A total of 15 patients presented with lack of keratinized mucosa after implant placement (less than 2mm). they all receive free gingival grafts in the deficient areas, the grafts were stabilized using titanium tacks instead of conventional suturing techniques . Digital photographs with graduated periodontal prop in all of them were taken at base line, 1M, 3M and 6M follow up. The graft shrinkage was evaluated using the calibrated intraoral photographs via the image j software. pain was evaluated using the visual analogue score, bleeding and edema using binary questions.
Results: 1- for the amount of the graft shrinkage, there was a statistically significant difference in the amount of shrinkage at different time intervals (P<0.001). The significantly highest amount of shrinkage occurred from baseline to 6 months (40.97% ± 2.55). The highest amount of shrinkage per month was observed after 1 month post-operative (27.64% ± 3.75) the amount of shrinkage from 1 month to 6 months post-operative (18.31% ± 3.77) and that from 3 months to 6 months post- operative (11.36% ± 3.60). While the significantly least amount of shrinkage occurred from 1 month to 3 months (7.81% ± 2.98). 2- For pain assessment, VAS mean values were statistically significantly highest at day 1 and day 2. There was a gradual significant decrease in VAS mean values in the following days (from day 3 to day 6). VAS mean value was significantly lowest at day 6. 3- For edema &bleeding, Chi-square test showed that the incidence of post-operative bleeding was significantly higher at day 1 than day 3, 4, 5 and 6; but did not differ significantly from day 2. While, the incidence of post-operative bleeding at day 2 was statistically similar to day 3, 4, 5 and 6. And for edema, it showed that the incidence of post-operative
edema was significantly higher at day 2, 3 and 4 than at day 1 and 6. While, the incidence of post-operative edema at day 5 did not differ significantly from day 1, 2, 3, 4 and 6.
Conclusion: Using this technique, the free gingival graft healed uneventfully and remained stable for six months follow up. So, this technique of (FGG) fixation offers an alternate to graft fixation with sutures and tissue adhesives, however more studies are needed to confirm this technique.