Gum Grafting

(Connective Tissue Graft – Free Gingival Graft – VISTA – Pinhole – VIPCTG – Alloderm – Dermis)

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.

When there is only minor recession, some healthy gingiva 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 first line of defense against bacterial penetration is lost.

In addition, gum recession often results in root sensitivity to hot and cold foods as well as an unsightly appearance of the gum and tooth. When significant, gum recession can predispose to worsening recession and expose the root surface, which is softer than enamel, leading to root caries and root gouging.

 
before and after gum grafting

A gingival graft is designed to solve these problems. A thin piece of tissue is taken 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.

Gum grafting is perform with 3 objectives in mind:

  1. To stop the vicious cycle of progressive loss of attachment and the associated underlying bone which is the foundation of the tooth.

  2. Create an environment that is more conducive to health and is more resistant to further tissue breakdown in the future.

  3. Attempt to regain back parts of the tissue initially lost to recession. This cannot always be achieved as it is dependant on the severity of the initial recession. Only obtainable in Miller Class I and II recession defects. In cases of Class III defects only partial coverage is possible up to the level of the adjacent bone. And not obtainable at all in Class IV defects.

In cases where residual root surfaces remain sensitive a “topical” application of root desensitizing age may be utilized to help alleviate any residual root sensitivity. Typically this is performed in multiple appointments around 6 months after the graft surgery.

These procedure are very routine and are typically performed simply with local anesthesia in our office and patient can return to work the next day.

In cases where the patient has dental anxiety, the procedure can be provided under IV sedation for extra comfort. In these cases the patient will need to be accompanied to the appointment with an accompanying adult to take them home after the procedure.