What is Mucogingival Surgery?
When recession of the gingiva (gums) occurs, it’s important to realize that it isn’t just the gums that are receding, but the tooth is also loosing the underlying supporting bone. As the tooth loses this jawbone and gum tissue, the tooth loses its natural defense (barrier) against both bacterial penetration and trauma. To stop the progression of gum and jawbone loss mucogingival surgery is performed. The goal of mucogingival surgery is to stop the recession and to create healthy gum tissue acting as a barrier against bacterial penetration, inflammation, and trauma for the tooth.
When Do I Need Mucogingival Augmentation?
When recession is advanced or reaches the junction where our tissues transition from gingiva (attached to the underlying bone) to mucosa (the movable oral tissue), recession can advance rapidly thereby destroying more supporting bone that surrounds your tooth. Healthy attached gum tissue is the first line of defense against bacterial penetration. With advancing recession this first line of defense is lost. Gum or soft tissue grafting is performed to correct this problem. This newly grafted soft tissue not only improves your oral health but your overall health as well. Esthetics and comfort are other reasons for performing soft tissue graft surgery. Often, the gum graft improves the esthetics of the person’s smile and can significantly help with root sensitivity (cold). When there is only minor recession and some healthy attached gum tissue remains to protect the tooth, often no treatment is indicated. In such cases modifying home care practices or checking and correcting one’s bite is all that is needed.
Drs Ira and Lori will perform a complete examination including assessing any areas of recession and will give you scientific reasons for the treatment they deem necessary. They will also review grafting options with you so you can partake in determining the best option for treating your recession.
Are There Different Kinds of Gum Grafts?
The are several different kinds of gums graft and gum graft techniques. Periodontists have specialized training in grafting procedures and many factors are involved in the recommended procedure. Drs. Ira and Lori will discuss your situation and they will recommend the procedure they feel would best address your recession needs. They will thoroughly explain the pros and cons of each option and you will be engaged in the decision making process.
- Subepithelial Connective Tissue Graft – This procedure is commonly used to treat and cover exposed roots. During the procedure, a flap of skin at the palate is removed for access to tissue under flap called subepithelial connective tissue (graft tissue). Then subepithelial connective tissue is relocated and stitched to the gum tissue surrounding the exposed root and the flap is stitched back down on the palate.
- Detached Gingival Graft – This procedure is often used to thicken gum tissue. A layer of tissue is removed directly from the palate or another donor surface without making a flap and attached to the area affected by gum recession. This method is used mostly in people who have thin gum and need additional tissue to enlarge the gum. Both gum and graft side will heal without any permanent damage.
- Acellular Dermal Matrix Allograft – This procedure is commonly used to cover exposed root by using medically processed and donated human tissue for the graft.
- Pinhole Surgical TechniqueTM (PST) – The Pinhole Surgical TechniqueTMcorrects receding gum but instead of transferring tissue, it utilizes the gum tissue at the treatment site by loosening the tissue that holds your gum tissue above a single tooth and gently lowering it to cover an exposed root. Thus, no scalpels or stitches needed.
What Should You Expect After the Procedure?
Tissue grafts are performed to provide a stable band of attached gum over the root to protect the underlying bone and root of the tooth. The gingival graft may be placed in such a way as to either cover the whole root or only cover an exposed portion of the root. The primary objective of this procedure is to gain firm attached gum tissue around the teeth for better protection against gum disease, inflammation, and bone loss.