Surgical Procedures
Gum Grafting Procedures
Free Gingival Grafts
(Subepithelial connective tissue grafts)
Gum Grafting MultiMedia
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When recession of the gingiva occurs, the body loses a natural defense against both bacterial penetration and trauma. When gum recession is a problem gum reconstruction using grafting techniques is an option. This is critical to understand because after minor gum recession is left untreated, continued recession always is combined with bone loss around teeth. Gum recession should never be treated by bonding the teeth without understanding this only protects the teeth, but in no way deals with the recession or prevents future periodontal issues.
When there is only minor recession, some healthy gingiva (the strong, pink, non-movable gum tissue which surrounds our teeth) often remains and protects the tooth, so that no treatment other than modifying home care practices is necessary. However, when recession reaches the mucosa (the red, movable weaker tissue), the first line of defense against bacterial penetration is lost. It is at this point that bone loss has also initiated.
In addition, gum recession often results in root sensitivity to hot and cold foods as well as an unsightly appearance to the gum and tooth. Also, gum recession, when significant, can predispose to worsening recession and expose the root surface, which is softer than enamel, leading to root caries and root gouging.
A gingival graft is designed to solve these problems. A thin piece of tissue is grafted from the roof of the mouth, or gently moved over from adjacent areas, to provide a stable band of attached gingiva around the tooth. The gingival graft may be placed in such a way as to cover the exposed portion of the root.
The gingival graft procedure is highly predictable and results in a stable healthy band of attached tissue around the tooth. Surgical innovations in the past 20 years have drastically changed these grafting procedures. The piece of gingiva from the palate is no longer left as an open would causing patient discomfort. In addition, in some cases, an allograft can be utilized. This is a piece of tissue that is taken from a donor, in the same fashion as a bone graft, and treated by groups like the American Red Cross. No disease transmission has ever been reported with the allografts in dentistry. They circumvent the need to graft form patients palates to add attached gingiva (pink gum tissue) around teeth.
Mucogingival (Soft Tissue) Surgery
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Patient presents with gingival recession isolate to the maxillary canine (“eye tooth”). Patient reports sensitivity to cold and is unhappy with appearance |
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One procedure (a sub-epithelial connective tissue graft) is performed to achieve result. Full root coverage is obtained. Patient is pleased with 100% root coverage and blending with adjacent tissues. Root sensitivity has ceased following periodontal therapy. |
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Patient presents with gingival recession isolate to the maxillary central incisor. Patient has sensitivity and would like gingival levels of central incisors to match |
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One procedure (a sub-epithelial connective tissue graft) is performed to achieve result. Full root coverage is obtained. Patient is pleased with 100% root coverage and blending with adjacent tissues. Root sensitivity has ceased following periodontal therapy. |
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Patient presents with gingival recession isolate on multiple teeth (maxillary premolars). |
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One procedure for multiple teeth (a sub-epithelial connective tissue graft) is performed to achieve result. Full root coverage is obtained. Patient is pleased with 100% root coverage and blending with adjacent tissues. |
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| Before Gingival Graft |
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After Gingival Graft |
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