Gingival Grafts

Gingival (or gum tissue) grafts are usually performed in situations where there is either recession that exposes root structure, an inadequate band of attached gingiva (tough, firmly attached gum tissue), instability or a pull of the margin of the gum tissue or not enough bulk of gum tissue in an area. Several types of grafting procedures can be done to achieve the desired results. You will be given a full explanation of your specific situation and the type of graft that is recommended for you.

Before		After

Most commonly, grafts are done to stabilize the tissue where there is a pull of the gum tissue margin and an inadequate zone of attached gingiva. In that case, a standard free gingival graft is done. “Free” here indicates that the donor tissue is freed from its original blood supply in order to be transferred to the new location, not related to the cost of the procedure. It relies on circulation from the bed preparation to ensure its survival. It is the most predictable surgical procedure that we do, and if root coverage is not required, it is the graft of choice. In this procedure, a thin piece of tough surface skin tissue is removed from one area and transplanted to the area of need. The donor site will heal much like a scrape or blistered area.

Root coverage can be less predictable than stabilization, and may be done by several methods. Sometimes, a standard free gingival graft may be done to create tough tissue, then at a second stage surgery that tissue is pulled over the root of the tooth as a flap and reattached. Sometimes it can be achieved by a subepithelial graft, where donor tissue is interposed between existing tissue and the root, altering the gum tissue level. In some situations, there is enough tough tissue adjacent to the site, and a pedicle graft can be shifted laterally, bringing its own blood supply with it.

In some situations, if there is a defect in the tissue contour where a pontic, or false tooth, is planned as a part of a bridge, a graft can augment the tissue contours, providing more bulk to enable the restorative dentist to create a pontic that looks more like a natural tooth. This is done as a subepithelial type of graft, and may require two or more procedures to achieve the desired tissue bulk and contour.

Q: How long does the procedure take?
A: Approximately 40-60 minutes, depending on the size and type of the graft.

Q: Where do you take the graft from?
A: The donor tissue usually comes from the roof of your mouth near the back teeth. It has been described as feeling like a "pizza burn" as it is healing.

For more information please visit: American Academy of Periodontology