Gum Grafting (Root coverage and /or stabilizing gingival width increase)

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

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

• Free gingival graft – This procedure is often used to thicken gum tissue. A layer of tissue is removed from the outer layer of palate and relocated to the area affected by gum recession.
  
  
• Subepithelial connective tissue graft – This procedure is commonly used to cover exposed roots. Tissue is removed from the upper palate and relocated to the site of gum recession.
  
  
• 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, minimizing felt pain after surgery.

Reasons for gingival grafting:

• Reduced sensitivity – When a tooth's 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 health the gums and teeth.
  
  
• 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.” Gum grafting can make the teeth look shorter and more symmetric.
  
  
• Improved gum health – Gingival grafting can promote gum health by restoring adequate blood flow to areas affected by periodontal disease or areas with naturally inadequate gingival width. Improved blood flow to these areas helps with overall tooth health.

What does gingival grafting treatment involve?

Once the need for gum grafting surgery has been determined the teeth must first be thoroughly cleaned to remove plaque,  calculus (tartar), and bacteria. The periodontist can also provide literature, advice and educational tools to increase the effectiveness of homecare and help reduce susceptibility to periodontal disease in the future.

Gingival grafting procedures are 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 usually placed to further stabilize the graft and to prevent any shifting from the designated site. A surgical dressing material is used to protect the surgical area during the first week of healing and a surgical stent is made from an impression of the upper arch to cover and protect the palatal wound as it heals.  Uniformity and healing of the gums will be achieved in approximately six weeks.

If you have any questions about gum grafting, please ask your dentist.