Periodontics

Gum graft

Periodontal plastic surgery or mucogingival surgery are the techniques aimed at improving soft tissue: the gum.

Muco-gingival surgery brings together the different techniques of gingival grafts.

They are often aimed at the treatment of gingival recessions.

What is a gum recession?

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

What are the causes of a gum recession?

Recessions are multi-factorial; this means that several factors are responsible for their appearance.

The factors favoring:

  • fine and weakly keratinized gum
  • low height of keratinized tissue
  • dental malposition
  • proximity to the labial frenulum

The triggering factors:

  • gum inflammation
  • mechanical damage due to inappropriate brushing, too strong
  • some dental movements performed during orthodontic treatments
  • “piercing” type jewelry
  • poorly adapted dental care
  • onychophagy, biting your nails
  • bulimia and anorexia
Periodontics - Geneva

What are the consequences of a gum recession?

  • Reduced protection: the gum acts as a barrier and protection for the bone. If it shrinks, the gum is thinner and often less protective, and the underlying bone also shrinks: you lose support for the tooth. In addition hygiene is more complicated, by access and sensitivity, which increases the risk of periodontal disease.
  • Tooth sensitivity: a tooth whose gum retracts, exhibits an exposure of its root which is no longer protected. It can sometimes be sensitive to cold, hot or sugary foods.
  • Root erosion: the root, which is no longer protected by the gum, is exposed to mechanical bacterial and chemical stresses, which can lead to erosion, destruction of part of the root.
  • Elongated tooth: visually, the gum leaving appear more root, the teeth seem to elongate. The tooth is always the same length, the problem comes from the position of the gum.

What are the treatments for a gum recession?

Treatments for gingival recession are mainly surgical.

The gum tissue is moved to cover the recession and gum (graft) is added to correct the thickness.

The techniques have evolved enormously in recent years, the microsurgical interventions used are micro-invasive generally offering more aesthetic results, more reliable, and with little pain.

With his techniques, post-operative pain is classified as discomfort only.

What are the different grafting techniques?

There are many techniques and variants, but we can mention 2 of the main techniques:

  • Gingival graft:

The oldest technique, a piece of gum on the palate is taken, then placed on the area where you lack gum after preparing a bed.

This transplant is the simplest to perform, but it has many disadvantages. The palate leaving a sore bare, this creates post-operative pain. The grafted gum provides a solid protective tissue but it very poorly covers recessions and often has an unattractive whitish color.

  • Connective tissue graft in a tunnel:

The most sophisticated technique, only a thin thickness of the inner part of the gum of the palate or the area of ​​the wisdom tooth is removed.

The removal from the palate is done with a single incision, which leaves you with an almost intact and protected palate for healing.

The graft is then slipped under the gum, thanks to threads, on the area where you lack gum, after having prepared a tunnel with micro-instruments.

This graft is the most technical but has many advantages. The sampling area at the palace is protected. The grafted gum is also covered and the esthetic aspect is already suitable just after the intervention. This allows only post-operative discomfort.

The grafted gum provides a thicker tissue preventing recurrences. The results of recession recoveries are high (around 80% recovery and 50% of patients have 100%). The aesthetic aspect is perfect by the absence of incision.

It is possible to use collagen substitutes in order to avoid a sample. However, their results are much lower than the grafts that are taken from you.

With the evolution of sampling techniques and their weak operating suites, sampling is often preferred.

Clinical case #1

Connective tissue graft in a tunnel technique

Clinical case #2

Palatal graft harvest

Clinical case #3

Connective tissue graft in a tunnel technique

Clinical case #4

Connective tissue graft in a tunnel technique

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