Gingival graft: Difference between revisions

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A gingival graft (also called gum graft or periodontal plastic surgery^[1]^[2]^[3]^[4]) 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.

Specific procedures

Coronally and apically positioned flaps , although technically not grafting procedures, are other forms of a pedicle grafts in that gingival tissue is freed up and moved either coronally or apically. This requires adequate thickness and width of gingival tissue at the base of the recession defect.

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 ^[5], 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.

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.

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 ^[6], while others believe it is equally successful as a subepithelial connective tissue graft. ^[7]

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.

Sources

External links

Gum Graft Patient Experiences

References

^ http://www.scholesperio.com/surgical_procedures/gum_graft.html
^ http://www.drcindylayport.com/surgical-therapy.php
^ http://www.sfperiodontist.com/question12.html
^ http://www.aboutcosmeticdentistry.com/procedures/gum_surgery/index.html
^ See article by Wennstrom et al. in the journal Annals of Periodontology, 1996
^ See article by Harris et al. Journal of Periodontology, 2004.
^ See article by Hirsch et al. in the Journal of Periodontology, 2005

[1] ttp://www.scholesperio.com/surgical_procedures/gum_graft.html

[2] ttp://www.drcindylayport.com/surgical-therapy.php

[3] ttp://www.sfperiodontist.com/question12.html

[4] ttp://www.aboutcosmeticdentistry.com/procedures/gum_surgery/index.html

[5] See article by Wennstrom et al. in the journal Annals of Periodontology, 1996

[6] See article by Harris et al. Journal of Periodontology, 2004.

[7] See article by Hirsch et al. in the Journal of Periodontology, 2005

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 ==Specific procedures==
+'''Coronally''' and '''apically positioned flaps''' , although technically not grafting procedures, are other forms of a pedicle grafts in that gingival tissue is freed up and moved either [[Commonly used terms of relationship and comparison in dentistry|coronally]] or [[Commonly used terms of relationship and comparison in dentistry|apically]].  This requires adequate thickness and width of gingival tissue at the base of the recession defect.
 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 <ref>See article by Wennstrom et al. in the journal ''Annals of Periodontology'', 1996</ref>, 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 [[periodontist]]s believe it may be less successful <ref>See article by Harris et al. ''Journal of Periodontology'', 2004.</ref>, while others believe it is equally successful as a subepithelial connective tissue graft. <ref>See article by Hirsch et al. in the ''Journal of Periodontology'', 2005</ref>
 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.
+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 [[periodontist]]s believe it may be less successful <ref>See article by Harris et al. ''Journal of Periodontology'', 2004.</ref>, while others believe it is equally successful as a subepithelial connective tissue graft. <ref>See article by Hirsch et al. in the ''Journal of Periodontology'', 2005</ref>
-'''Coronally''' and '''apically positioned flaps''' , although technically not grafting procedures, are other forms of a pedicle grafts in that gingival tissue is freed up and moved either [[Commonly used terms of relationship and comparison in dentistry|coronally]] or [[Commonly used terms of relationship and comparison in dentistry|apically]].  This requires adequate thickness and width of gingival tissue at the base of the recession defect.
 ==Risks==