Attached Gingiva

Attached gingiva is the firm, keratinized gingiva extending from the base of the gingival sulcus to the mucogingival junction. It is firmly attached to the underlying alveolar bone and plays a vital role in maintaining periodontal health by resisting mechanical trauma, facilitating plaque control, and preserving gingival stability and esthetics. Its width and thickness vary among individuals and tooth regions, and current evidence suggests that adequate plaque control is more important than a specific width of attached gingiva. Gingival biotype significantly influences treatment outcomes, with thick biotypes showing greater resistance to inflammation and recession than thin biotypes. Attached gingiva is also important around dental implants, where it enhances patient comfort, oral hygiene, and peri-implant tissue stability. When clinically indicated, procedures such as free gingival grafts, connective tissue grafts, and apically positioned flaps are performed to increase the width or thickness of attached gingiva and improve long-term functional and esthetic outcomes.