Evaluation of gained vestibular depth, pain perception and healing response following three different methods of vestibular deepening surgical techniques - A comparative clinical trial.

Background: Vestibular deepening procedure is a surgical intervention, intended to correct the insufficient vestibular depth (VD) and keratinized gingiva, both of which can compromise gingival health and hinder the maintenance of oral hygiene. The aim of this study is to assess and compare the gained VD, patient perception, and healing outcome in periosteal fenestration, Kazanjian, and free gingival grafting (FGG) techniques of vestibular deepening for a period of 6 months. Materials and Methods: Thirty patients presenting with a shallow vestibule in the anterior mandibular region, requiring improved VD or increased width of attached gingiva for effective oral hygiene maintenance, were included in the study. Clinical parameters like plaque index, gingival index, VD, and keratinized tissue width (KTW) were recorded at baseline and postoperatively at 1, 3, and 6 months. Healing outcomes and patient perception of pain were recorded by Landry et al., using healing index and Visual Analog Scale (VAS) score, respectively. Results: All the three techniques resulted in a statistically significant improvement in VD at all time intervals (P < 0.05). Patients treated with the periosteal fenestration approach had less pain and better healing outcome than patients treated with the other two approaches. Free gingival graft resulted in better gain in VD and keratinized tissue. Conclusion: The results of our clinical study showed that the periosteal fenestration group had better healing outcomes and less pain perception, while the FGG group had more improvement in VD and keratinized tissue.