This randomized controlled clinical trial evaluated the effectiveness of butyl-cyanoacrylate tissue adhesive compared with conventional sutures for stabilization of free gingival grafts. Twenty-four patients with insufficient keratinized tissue were randomly assigned to either cyanoacrylate or suture stabilization following free gingival graft surgery. Clinical parameters, graft dimensional changes, patient-reported postoperative discomfort, and operative time were assessed over a 6-month follow-up period.

Inclusion Criteria:

• Adults aged 18 years or older
• Presence of ≤1 mm of keratinized tissue and/or Miller Class I gingival recession ≤2 mm affecting one to four mandibular anterior teeth
• Vital teeth in the surgical area
• Good oral hygiene following initial periodontal therapy (full-mouth plaque score and full-mouth bleeding score ≤20%)
• Ability to understand the study procedures and provide written informed consent

Exclusion Criteria:

• Current smokers
• Pregnancy or lactation
• Use of systemic antibiotics within the previous 6 months
• History of periodontal surgery in the study area
• Ongoing orthodontic treatment
• Systemic conditions that could affect periodontal healing

Clinical outcome measurements were performed by an examiner blinded to group allocation.