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Suture-less Free Gingival Grafting with Platelet-rich Fibrin

Periodontal and Biofilm Diseases of the Mouth

Presented by: Nathan E. Estrin, DDS, MSC

Original Publication Date: August 22, 2025 (Webinar Series)

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Course Description:

Insufficient attached tissue is a significant mucogingival problem around both teeth and implants, as a thinner band of keratinized tissue is necessary for protective measures against masticatory function and is also painful for patients to brush properly. If left untreated, insufficient attached gingiva is associated with increased recession, soft tissue inflammation, and plaque formation. Free gingival grafts (FGGs) are commonly utilized to increase the amount of keratinized tissue around both teeth and implants. Traditionally, autogenous grafts harvested from the palate of patients and are fixated to the recipient site utilizing a wide array of suturing techniques.

In this lecture, a simplified suture-less method to free gingival grafting is demonstrated and explained step-by-step, utilizing medical-grade tissue adhesive and Coe-Pak as a way to avoid sutures entirely, making the procedure simpler and faster to perform, saving valuable chairside time for the clinician and patient. To improve on this technique, by utilizing platelet-rich fibrin (PRF) clinicians are able to minimize the pain experienced at the donor site by placing PRF on the palate which also helps eliminate the need for sutures at this site. Now the technique is truly suture-less, allowing clinicians to increase the amount of keratinized tissue in a very fast and predictable way. 

The simplified suture-less free gingival grafting technique is a predictable method to rapidly and confidently secure free gingival grafts around teeth and implants to increase the amount of keratinized and attached tissue.

Learning Objectives:

  • Understand the importance of keratinized tissue and how to diagnose a lack of attached tissue.
  • Learn step by step the simplified suture-less free gingival grafting technique.
  • How to treat the palate after harvesting free gingival grafts.

Practical Applications for Dentists & Hygienists:

  • Educating patients on the importance of keratinized tissue
  • Performing the sutureless free gingival grafting technique to help patients with inadequate keratinized tissue
  • Minimizing pain experienced by patients at the donor site by utilizing a combination of PRF, StellaLife, and a palatal stent. 

Conflicts of Interest: 

Affiliated with StellaLife