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A gingival graft (also called gum graft or periodontal plastic surgerycitation needed) is a generic name for any of a number of surgical periodontal procedures whose combined aim is to cover an area of exposed tooth root surface with grafted oral tissue. The covering of exposed root surfaces accomplishes a number of objectives: the prevention of further root exposure, decreased or eliminated sensitivity, decreased susceptibility to root caries and improved cosmetic. These procedures are usually performed by a dental specialist in the field of gingival tissue, known as a periodontist, but may be performed by a general dentist having training in these procedures.
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Specific procedures
A free gingival graft is a dental procedure where a layer of tissue is removed from the palate of the patient's mouth and then relocated to the site of gum recession. It is stitched into place and will serve to protect the exposed root as living tissue. The donor site will heal without damage. This procedure is often used to increase the thickness of very thin gum tissue.
A subepithelial connective tissue graft takes tissue from under healthy gum tissue in the palate, which may be placed at the area of gum recession. This procedure has the advantage of excellent predictability of root coverage 1, as well as decreased pain at the palatal donor site compared to the free gingival graft. The subepithelial connective tissue graft is a very common procedure for covering exposed roots.
An acellular dermal matrix (such as Alloderm) graft uses donated medically-processed human skin tissue as a source for the graft. The advantage of this procedure is no need for a palatal donor site, however some periodontists believe it may be less successful 2, while others believe it is equally successful as a subepithlial connective tissue graft. 3
A lateral pedicle graft, or pedicle graft, takes tissue from the area immediately adjacent to the damaged gingiva. This is not always an option, as the constraint that there must be sufficient tissue immediately lateral to the area of interest is an onerous one. When this procedure is performed, the transplant tissue is cut away and rotated over the damaged area. This can place the donor area at risk of recession as well.
A coronally positioned flap , although technically not a grafting procedure, is another form of a pedicle graft in which gingival tissue is freed up and simply moved upwards on the tooth to cover the recession. This requires adequate thickness and width of gingival tissue at the base of the recession defect.
Risks
Excessive bleeding from the palatal donor site does occur in some patients. Also, if the graft fails to "take" the recession defect can be worsened.
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- This page was last modified on 15 December 2008, at 20:07.
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