Abstract
OBJECTIVE: To evaluate the clinical efficacy of a dual anchoring technique (DAT) for keratinized tissue width (KTW) augmentation in the posterior mandible, utilising a dual fixation system (orthodontic anchor screws and membrane tacks) to improve soft tissue stability and reduce graft contraction. MATERIALS AND METHODS: This retrospective case series included 25 systemically healthy patients with KTW <2 mm after bone augmentation. Primary outcome was KTW change from baseline (T₀) to 12 months (T₅). Secondary outcomes included graft shrinkage, operative time, complications and postoperative patient-reported outcome measures (PROMs). RESULTS: All 25 patients (49 implant sites) completed the 12-month follow-up. KTW increased from 0.67 ± 0.12 mm (T₀) to 11.00 ± 0.87 mm at 1 month, stabilising at 8.70 ± 0.84 mm at T₅ (net gain: 8.02 ± 0.82 mm; P < .001). Graft shrinkage was 17.48 ± 3.41% at T₅, with 85% occurring within the first 3 months. Mean operative time was 26.40 ± 1.9 min (single-site) and 33.31 ± 2.08 min (2-site). No complications occurred. VAS scores decreased to negligible levels by day 14. CONCLUSION: Within the limitations of this retrospective study, DAT was associated with effective keratinized tissue augmentation in the posterior mandible and favourable dimensional stability over a 12-month period. CLINICAL RELEVANCE: This study introduces DAT designed to reduce the contraction rate of free gingival grafts in the posterior mandible by enhancing their mechanical stability. This technique offers a reliable, practical and a simple surgical protocol for predictable keratinized tissue augmentation in this region.