Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 6, 2021; 9(34): 10738-10745
Published online Dec 6, 2021. doi: 10.12998/wjcc.v9.i34.10738
Peri-implant keratinized gingiva augmentation using xenogeneic collagen matrix and platelet-rich fibrin: A case report
Chun-Yu Han, De-Zhou Wang, Jian-Fei Bai, Lan-Lan Zhao, Wen-Zhi Song
Chun-Yu Han, De-Zhou Wang, Jian-Fei Bai, Lan-Lan Zhao, Wen-Zhi Song, Department of Stomatology, China-Japan Union Hospital, Jilin University, Changchun 130031, Jilin Province, China
Author contributions: Zhao LL and Wang DZ contributed to collecting clinical details; Han CY and Bai JF contributed to drafting and writing the manuscript; Song WZ made substantial contribution to manuscript revision; all authors reviewed and approved the final manuscript.
Supported by Industrial Technology Research and Development Project of Jilin Development and Reform Commission, No. 2021C042-2.
Informed consent statement: Written informed consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Wen-Zhi Song, PhD, Doctor, Department of Stomatology, China-Japan Union Hospital, Jilin University, No. 126 Xiantai Street, Jingkai District, Changchun 130031, Jilin Province, China.
Received: August 15, 2021
Peer-review started: August 15, 2021
First decision: September 2, 2021
Revised: September 14, 2021
Accepted: October 11, 2021
Article in press: October 11, 2021
Published online: December 6, 2021

Keratinized gingival insufficiency is a disease attributed to long-term tooth loss, can severely jeopardizes the long-term health of implants. A simple and effective augmentation surgery method should be urgently developed.


A healthy female patient, 45-year-old, requested implant restoration of the her left mandibular first molar and second molar. Before considering a stage II, as suggested from the probing depth measurements, the widths of the mesial, medial, and distal buccal keratinized gingiva of second molar (tooth #37) were measured and found to be 0.5 mm, 0.5 mm, and 0 mm, respectively. This suggested that the gingiva was insufficient to resist damage from bacterial and mechanical stimulation. Accordingly, modified apically repositioned flap (ARF) surgery combined with xenogeneic collagen matrix (XCM) and platelet-rich fibrin (PRF) was employed to increase the width of gingival tissue. After 1 mo of healing, the widths of mesial, medial, and distal buccal keratinized gingiva reached 4 mm, 4 mm, and 3 mm, respectively, and the thickness of the augmented mucosa was 4.5 mm. Subsequently, through the second-stage operation, the patient obtained an ideal soft tissue shape around the implant.


For cases with keratinized gingiva widths around implants less than 2mm,the soft tissue width and thickness could be increased by modified ARF surgery combined with XCM and PRF. Moreover, this surgery significantly alleviated patients’ pain and ameliorated oral functional comfort.

Keywords: Keratinized gingiva augmentation, Xenogeneic collagen matrix, Platelet-rich fibrin, Case report

Core Tip: The advantages of keratinized gingiva augmentation with xenogeneic collagen matrix and platelet-rich fibrin included: (1) Promotion of soft tissue regeneration; (2) Low risks of infection and pain; (3) Minimally invasive procedure; and (4) Simplified surgical process.