Cosmetic Periodontal Surgery
Gingival recession is the exposure of the roots of teeth caused by loss of gum tissue and/or retraction of the gum margin away from the crown of the tooth. Cosmetic periodontal surgery offers patients the ability to correct recession, which can often be unattractive. This is especially important when the gums are visible when talking or smiling. Recession may cause your teeth to look longer than others and, in some cases, an exposed tooth root can cause severe pain because the root is exposed to extremes in temperature from different types of foods and liquids. Once the cause of the recession, or defect, is determined, cosmetic periodontal surgery can repair the defect, correct pain and/or sensitivity, and help prevent further recession and bone loss.
If only a few teeth are affected in a particular area, often a sub-epithelial connective tissue graft is the recommended treatment of choice. However, if several teeth in a particular area or an entire dental arch is affected, the use of acellular dermal matrix (alloderm) may be recommended.
Acellular dermal matrix (Alloderm)
For more information on this product please visit: www.biohorizons.com/alloderm.aspx
Sub-epithelial connective tissue graft
A sub-epithelial connective tissue graft is still the gold standard for correcting gingival recession and achieving root coverage on an affected tooth. For this procedure, local anesthesia is administered and the recipient site (the tooth with recession) is prepared to receive the graft. Next, a piece of connective tissue is harvested from the roof of your mouth. After this piece of tissue is removed, the donor site is sutured closed. The piece of connective tissue is then positioned on the affected root surface and sutured into place. The existing gums are then pulled up over the top of the connective tissue graft to help protect it during healing. Typically, no antibiotics are prescribed for this surgery and minimal post-operative pain medication is needed.
Soft tissue grafts can aid in correcting gum recession and help to thicken the gum tissue. In this video, a piece of connective tissue is harvested from the roof of the mouth and placed underneath a small pouch created in the site with deficient gums. Stitches are then placed and within 6 weeks the site if fully healed and the gum tissue is thickened.
Soft Tissue Augmentation
Gingival recession is the exposure of the roots of teeth caused by loss of gum tissue and/or retraction of the gum margin away from the crown of the tooth. When recession occurs, the body loses a natural defense mechanism against bacterial penetration and trauma (often from your toothbrush!). Sometimes, when only minor recession is present and some healthy gum remains to protect the tooth, no treatment other than modifying home oral hygiene is necessary. However, when gum recession becomes a problem, soft tissue augmentation is an option to repair lost and damaged tissue. This photo shows that there is no good, attached gum tissue surrounding this lower right molar. You can see the periodontal probe is passing through the thick, protective layer of coral pink gum tissue into the thin, non-attached red mucosa. In this case, a gingival graft was recommended to correct this defect.
A gingival graft is designed to re-establish a zone of thick, healthy, attached gum tissue surrounding a tooth or dental implant. A thin piece of tissue is taken from the roof of the mouth, or gently rotated from an adjacent area where thick, healthy tissue is present, to provide a band of thick, healthy, attached gum around the affected tooth or dental implant. Oftentimes this procedure not only protects your tooth or implant from further gum and bone loss, but also improves the appearance the tooth!
When a patient exhibits gum recession or deficient thickness, a soft tissue graft can be performed. An appropriate sized piece of tissue is harvested from the palate and transplanted to the recipient site.
Case Study 1
Patient presents with localized recession caused by a previous chin piercing
3 month post-operative photo showing correction of gum recession and thickening of tissue by placement of a gingival graft
Case Study 2
Patient presents with localized area of gingival recession and cold sensitivity
Gingival graft taken from palate and sutured into position
Photograph taken 2 months post graft showing correction of defect