SOFT TISSUE GRAFTS
Soft tissue grafting is the transfer of gum tissue from one area of the mouth to another. The primary purpose of soft tissue grafting is to build up the soft tissue in an area where soft tissue is lacking.
A good example of this is the treatment of gum recession on a tooth. Recession is the movement of the gums, up for the upper teeth and down for the lower teeth, exposing the root surface of the tooth/teeth. This process may be self limiting or continue to progress over time. The primary factor in the development and progression of recession is due to the minimal thickness of the gums and bone surrounding the teeth and/or position of the tooth in the jaw bone. Other factors that may affect recession are too aggressive of tooth brushing, too hard of a tooth brush and grinding and/or bruxing your teeth.
The main goal in soft tissue grafting of recession is thickening the soft tissue covering the tooth to prevent further recession. The secondary goal in soft tissue grafting is attempting to get coverage of the root that has been previously exposed by the recession. Unfortunately, root coverage is not always possible. The treating doctor should give you an idea on the predictability of getting coverage of the root in your situation.
Soft tissue grafting is a minor periodontal surgical procedure. The affected area (recipient site) and the donor site, are numbed with a local anesthesia, just as you would have with a filling. The receded area is prepared to receive the graft. The tissue is remove or released from the donor site and transferred to the recipient site. Both areas are usually sutured (stitched). The sutures are removed on about 1 week and you are given instructions on how to maintain the sites. While most grafts heal within 3-4 weeks, total healing and shaping takes a number of months.
Frequently Asked Questions
Gum or gingival recession is the movement of the gums resulting in exposure of the root surface of the tooth/teeth. The primary factor in the development and progression of recession is due to the minimal thickness of the gums and bone surrounding the teeth and/or position of the tooth in the jaw bone. Other factors that may affect recession are too aggressive tooth brushing, too hard of a tooth brush and grinding and/or bruxing your teeth.
The main goal in sift tissue grafting for recession is to thicken the soft tissue covering the tooth to prevent further recession. The secondary goal in soft tissue grafting is to attempt coverage of the root that has previously been exposed by the recession. Unfortunately, total root coverage is not always possible. Dr. John should be able to give you a pretty good estimate as to how much root coverage you can expect after the grafting.
Auto Grafts: This type of tissue comes from your own mouth. The sides of the roof of your mouth (adjacent to the molar and bicuspid areas) is the most common donor site. For the Free Gingival Graft, the graft is taken from the top 2mm surface of the roof of the mouth. For the Connective Tissue Graft, the graft is taken from just underneath the surface of the palate. The wound is usually smaller and heals faster than the Free Gingival Graft. Both donor sites are sutured.
Allo and Xeno grafts: The Allograft is tissue that is donated from another person. The allografts used for soft tissue grafting are a dermal matrix, collagen, that has all cellular components removed and ‘sterilized’ using a number of various techniques. The Xenograft is tissue taken from an animal, usually a cow, that has all the cellular components removed and ‘sterilized’ using a number of various techniques. Both of these grafts are very safe. Because the cellular components are removed, typical donor tissue rejection is not seen in these grafts.
Dr. John believes in the minimally invasive approach to soft tissue grafting. The tissues are reflexed just enough with microblades to place the graft. The most common soft tissue graft that Dr. John does is the Connective Tissue Graft using the patient’s own tissue. However, if Dr. John feels that the Allograft will give the same results as the Autograft, he will often times recommend the Allograft to spare his patient’s the additional trauma of having the palate as a secondary surgical site. Dr. John will only recommend an Allograft from one of two extremely reputable companies. Dr. John has had years of experience using and perfecting the use of the Allodermal grafts.