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