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Laureen Langer, DDS
Burton Langer, DMD
Creating Beautiful Smiles
Call: (212) 772-6900

Gum Recession

A gum graft (also known as a gingival graft or periodontal plastic surgery), is a collective name for many different surgical periodontal procedures that aim to cover an exposed tooth root surface with grafted oral tissue.

Exposed tooth roots are usually the result of gingival recession due to periodontal disease. There are other common causes, including overly aggressive brushing and trauma. 


Connective Tissue Gum Grafting Long-Term Results
by Dr. Langer

 

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Here are some of the most common types of gum grafting:

  • Free gingival graft – This procedure is often used to thicken gum tissue. An outer layer of tissue is removed from the palate and relocated to the area affected by gum recession. Both sites will quickly heal without permanent damage.

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FREE GINGIVAL GRAFT PROCEDURE
  • Subepithelial connective tissue graft – In 2015 the American Academy of Periodontology Regeneration Workshop concluded that this procedure (SCTG) is considered the "gold standard" for treating gum recession due to it's long lasting and well documented success rate (more than 30 years). Tissue is removed fairly painlessly from the inner layer of the palate and relocated to the site of gum recession. The advantages are that the tissue becomes thicker, matches the adjacent tissue in texture and color and has initial healing in one week. (See examples below)

  • Acellular dermal matrix allograft – This procedure uses medically processed, donated human tissue as a tissue source for the graft. The advantage of this is procedure is that there is no need for a donor site from the patient’s palate (and thus, less pain).

  • Chao Pinhole® Surgical Technique (PST®) - This procedure is performed by making small holes with a needle in the gum tissue. Using specially designed instruments, the gum tissue is loosened and guided over the receded part of the tooth. No palatal donor tissue is necessary.

Chao Pinhole® Surgical Technique (PST®) Results
by Dr. Langer

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AFTER

Reasons for gum grafting

Gum grafting is a common periodontal procedure. Though the name might sound frightening, the procedure is commonly performed with excellent results.

Here are some of the major benefits associated with gum grafting:

  • Reduced sensitivity – When the tooth root becomes exposed, eating or drinking hot or cold foods can cause extreme sensitivity to the teeth. Gum grafting surgery permanently covers the exposed root, helps reduce discomfort, and restores the good health of the gums.

  • Improved appearance – Periodontal disease is characterized by gum recession and inflammation. Gum recession and root exposure can make the teeth look longer than normal and the smile to appear “toothy” or older. Gum grafting can make the teeth look shorter, more symmetrical and generally more pleasing to look at. In addition, adjacent tissue can be enhanced and augmented during the procedure for aesthetic purposes.

  • Improved gum health – Periodontal disease can progress and destroy gum tissue very rapidly. If left untreated, a large amount of gum tissue can be lost in a short period of time. Gum grafting can help halt tissue and bone loss; preventing further problems and protecting exposed roots from further decay.

What does gum grafting treatment involve?

Once the need for gum grafting surgery has been determined, there are several treatments the dentist will want to perform before gum grafting takes place. First, the teeth must be thoroughly cleaned supra and subgingivally to remove calculus (tartar) and bacteria. The dentist can also provide literature, advice and educational tools to increase the effectiveness of home care and help reduce the susceptibility of periodontal disease in the future.

The gum grafting procedure is usually performed under local anesthetic. The exact procedure will depend much on whether tissue is coming from the patient’s palate or a tissue bank.

Initially, small incisions will be made at the recipient site to create a small pocket to accommodate the graft. Then a split-thickness incision is made and the connective tissue graft is inserted into the space between the two sections of tissue. The graft is usually slightly larger than the recession area, so some excess will be apparent.

Sutures are often placed to further stabilize the graft and to prevent any shifting from the designated site. Surgical material is used to protect the surgical area during the first week of healing. Uniformity and healing of the gums will be achieved in approximately six weeks.

 

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