Gum Grafting

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.

Progressing recession is recession that is increasing over time.  Without intervention, this recession will likely continue to progress and may cause bone loss, sensitivity and, ultimately, tooth loss.

How do you know if you have progressing recession? First and foremost, monitoring your recession to see if it has become worse over time.  If you haven’t monitored your recession, periodontal literature has shown that recession defects that are 3mm have a 67% chance of progressing and recession defects that are 4mm have a 100% chance of progressing.  Ask your dentist how much recession you have.  If he/she tells you 3mm or 4mm, then you need to have a consultation to determine if a soft tissue graft is indicated for you.

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. Examples:

An aesthetic modification of the technique above is called a connective tissue graft. It involves harvesting the layer of tissue below the epithelium of the palate and using it as a graft around teeth with recession.  Examples:

In specific cases which involve generalized recession, an allograft (donor tissue) may be used to regenerate the gingival tissues and achieve root coverage. Examples: