{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T21:41:07Z","timestamp":1789594867508,"version":"build-2803163510"},"reference-count":54,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2023,5,24]],"date-time":"2023-05-24T00:00:00Z","timestamp":1684886400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["aap.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Periodontology"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>A 13\u2010year follow\u2010up was conducted of a short\u2010term investigation of the use of living cellular construct (LCC) versus free gingival graft (FGG) for keratinized tissue width (KTW) augmentation in natural dentition, to evaluate the long\u2010term outcomes and assess the changes occurring since the end of the original 6\u2010month study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Twenty\u2010four subjects out of the original 29 enrolled participants were available at the 13\u2010year follow\u2010up. The primary endpoint was the number of sites demonstrating stable clinical outcomes from 6 months to 13 years (defined as KTW gain, stability, or \u22640.5\u00a0mm of KTW loss, together with reduction, stability, or increase of probing depth, and recession depth [REC] \u22640.5\u00a0mm). Secondary outcomes included the assessment of KTW, attached gingiva width (AGW), REC, clinical attachment level, esthetics, and patient\u2010reported outcomes at the 13\u2010year visit, assessing the changes from baseline to 6 months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Nine sites per group (42.9%) were found to have maintained stable (\u22640.5\u00a0mm or improved) clinical outcomes from 6 months to 13 years. No significant differences were observed for the clinical parameters between LCC and FGG from 6 months to 13 years. However, the longitudinal mixed model analysis showed that FGG delivered significantly better clinical outcomes over 13 years (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.01). LCC\u2010treated sites exhibited superior esthetic outcomes compared to FGG\u2010treated sites at 6 months and 13 years (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.01). Patient\u2010evaluated esthetics were significantly higher for LCC over FGG (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.01). Patient overall treatment preference was also in favor of LCC (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A similar stability of the treatment outcomes from 6 months to 13 years was found for LCC\u2010 and FGG\u2010treated sites, with both approaches shown to be effective in augmenting KTW and AGW. However, superior clinical outcomes were found for FGG over 13 years, while LCC was associated with better esthetics and patient\u2010reported outcomes than FGG.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jper.23-0040","type":"journal-article","created":{"date-parts":[[2023,5,3]],"date-time":"2023-05-03T12:14:55Z","timestamp":1683116095000},"page":"1302-1314","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Living cellular constructs for keratinized tissue augmentation: A 13\u2010year follow\u2010up from a split\u2010mouth randomized, controlled, clinical trial"],"prefix":"10.1002","volume":"94","author":[{"given":"Lorenzo","family":"Tavelli","sequence":"first","affiliation":[{"name":"Department of Oral Medicine Infection, and Immunity Division of Periodontology Harvard School of Dental Medicine  Boston Massachusetts USA"},{"name":"Department of Periodontics &amp; Oral Medicine University of Michigan School of Dentistry 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