When recession of the gingiva occurs, the body loses a natural defense against both bacterial penetration and trauma. This can eventually lead to an inadequate amount of attached gingiva, increasing the risk for gum disease and eventual tooth loss. If the recession is minor and some healthy gingiva remains to protect the tooth, no treatment is necessary, other than modifying home care practices to prevent further recession. However, when recession reaches the mucosa, the first line of defense against bacterial penetration is lost.
We can restore gum tissue using innovated gingival grafting techniques for functional and cosmetic health. Here are the main types of gum grafting techniques:
- Connective Tissue Graft: During this procedure, a small flap of skin from the roof of the mouth is elevated and tissue is removed from under the flap. This connective tissue is then sutured to the recession site to increase attachment and gain root coverage. This is primarily done for both functional and cosmetic purposes.
- Free Gingival Graft: A thin piece of surface tissue is removed from the palate and stitched directly to the recession site to increase the
band of attached gingiva. This is primarily done for functional purposes. - Tissue Bank Graft: In addition to using natural grafts from the patient, it is possible to use graft material Allograft from a tissue bank. This is primarily done in substitution for connective tissue grafts.
- Coronally Positioned Flap with Emdogain: A coronally positioned flap is when you manipulate the existing gum tissue and move it toward the tip of the tooth. This procedure is performed with virtually every soft tissue graft; however, this technique entails using only the existing tissue with the addition of a product called Emdogain.
Emdogain is a product that is purchased and comes in the form of a gel. This gel contains proteins and enzymes that induce tissue growth. The proteins are harvested from pigs and can be used to help regenerate lost bone or in this case, tissue growth.
The tissue is prepared in the site of the recession until it can be repositioned adequately. Then the tooth is treated with the gel and the tissue is sutured on top of the recessed tooth. The gel is then oozed all over the remaining site.
This technique works well and the surgical site is localized without having to make a wound on the roof of the mouth. There is minimal discomfort and requires only to be left alone during healing. The doctors will be very thorough about the post-operative instructions in order to ensure success.
The gingival graft procedure is highly predictable and results in a stable, healthy band of attached tissue around the tooth.
