Gum graft

Periodontal plastic surgery procedure.

Periodontal plastic surgery or mucogingival surgery involves techniques aimed at improving the soft tissues: the gums.

Mucogingival surgery encompasses various gingival grafting techniques.

These techniques are often used to treat gingival recessions.

What is gum recession?

A gingival recession is a retraction of the gum, a localized destruction of the gum that covers the dental root.

What are the causes of gum recession?

Gingival recessions result from multiple factors. Indeed, several elements contribute to their occurrence.

Favoring factors

First of all, several conditions can promote gingival recessions:

Thin and weakly keratinized gums
Low height of keratinized tissue
Dental malposition
Proximity of the labial frenulum

Triggering factors

In addition to the favoring factors, certain elements can trigger gingival recessions:

Gingival inflammation
Mechanical aggressions due to inappropriate and too vigorous brushing
Certain dental movements performed during orthodontic treatments
Jewelry such as piercings
Inadequate dental care
Onychophagia, which is nail biting
Eating disorders such as bulimia and anorexia

By understanding these factors, we can better prevent and treat gingival recessions.

What are the consequences of gum recession?

Reduction of protection:

The gum plays a crucial role as a barrier and protector for the bone. When the gum recedes, it becomes thinner and often less protective. The underlying bone also recedes, leading to a loss of tooth support. Additionally, hygiene becomes more complicated due to difficult access and increased sensitivity, thus raising the risk of periodontal disease.

Tooth sensitivity:

When the gum recedes, it exposes the root of the tooth which is no longer protected. This situation can cause increased sensitivity to cold, heat, or sweet foods.

Root erosion:

Without the protection of the gum, the root is exposed to mechanical, bacterial, and chemical stress. This exposure can lead to erosion and partial destruction of the root.

Elongated tooth:

Visually, gum recession exposes more of the root, giving the impression that the teeth are elongated. In reality, the length of the tooth remains unchanged; the issue stems from the position of the gum.

What are the treatments for gum recession?

We primarily treat gingival recessions through surgical interventions. To cover the recession, we move the gingival tissues and add gum (graft) to correct the thickness.

Advancement of techniques

Techniques have significantly evolved in recent years. Today, we use micro-surgery interventions that are minimally invasive. These methods generally provide more aesthetic and reliable results, with minimal pain.

Post-operative comfort

Thanks to these techniques, post-operative pain is usually classified as discomfort only.

What are the different grafting techniques?

We use numerous techniques and variations for gum grafts, but two main techniques stand out:

The epithelial-connective tissue graft

For this technique, we take a piece of gum from the palate. Then, we place it on the area where you lack gum tissue, after preparing a bed. This method, the oldest, is simple to perform. However, it has several drawbacks. Leaving an open wound on the palate creates post-operative pain. The grafted gum, although solid, does not cover the recessions well and often has an unattractive whitish color.

The Tunneling technique for connective tissue graft

For this more sophisticated technique, we take only a thin layer of the internal part of the gum from the palate or the wisdom tooth area. The harvesting from the palate is done with a single incision, leaving the palate almost intact and protected for healing. Then, we slide the graft under the gum, using sutures, in the area where you lack gum tissue, after preparing a tunnel with micro-instruments.

Although more technical, this method has many advantages. The harvesting area on the palate remains protected. The grafted gum is also covered, providing an aesthetically pleasing appearance immediately after the procedure, which reduces post-operative discomfort. The grafted gum provides thicker tissue, preventing recurrences. The results of covering recessions are high, with about 80% coverage and 50% of patients achieving total coverage. Additionally, the absence of an incision significantly improves the aesthetic aspect.