Treatment Options for Gum Recession, and Inadequate Gum Tissue Quality and/or Quantity
Recession, or loss of gum tissue, and inadequate gum tissue quality and quantity, may be treated with a variety of techniques depending on the following factors: amount of teeth that have recession, severity of recession present, amount of healthy attached/keratinized gingiva, and area of mouth being treated.
Connective Tissue Graft
All areas, best for moderate to severe recession and inadequate gum tissue quality or quantity in esthetic areas.
Preparation: After anesthesia, the roots of affected teeth are thoroughly cleaned, and a recipient bed is created to receive the graft tissue. The recipient bed is often incisionless, or otherwise known as a tunneling technique.
Tissue Harvesting: A small piece of tissue is taken from the roof of the mouth (palate). This tissue is usually located under a thin layer of skin and is called subepithelial connective tissue.
Placement: The harvested tissue is then placed over the exposed tooth roots in the tunnel, and secured with very small sutures.
Healing: Over time, the graft integrates with the existing gum tissue, providing root coverage and more healthy, thickened protective gum tissue.
Free Gingival Graft
All areas, especially with cases that need a significant increase in gum thickness. Typically not chosen for esthetic zones and most commonly performed on lower teeth.
Preparation: After anesthesia, the roots of the affected teeth are thoroughly cleaned, and a recipient bed is created to receive the graft tissue.
Tissue Harvesting: A small piece of tissue is taken from the roof of the mouth (palate). Unlike a connective tissue graft, which uses tissue from beneath the surface, a free gingival graft uses tissue directly from the surface layer of the palate and the underlying tissue.
Placement: The harvested tissue is then placed onto the area on the recipient bed where the gum has receded and needs to be thickened. The tissue is secured with very small sutures.
Allograft
All areas, especially if treating an entire arch or multiple teeth. This procedure is most predictable when there is recession but a reasonably adequate quantity and quality of gum tissue is present.
Preparation: After anesthesia, the roots of the affected teeth are thoroughly cleaned, and a recipient bed is created to receive the graft tissue.
Allograft Material: Instead of harvesting tissue from the patient’s palate, donor tissue from a tissue bank is used. This donor tissue is processed and sterilized to ensure it is safe and compatible with the patient’s body.
Placement: The allograft material is carefully placed in the tunnel and over he areas where the gums have receded. It is then secured with very small sutures.
Healing: Over time, the patient’s own gum tissue integrates with the allograft, promoting new tissue growth and covering the exposed roots.
Pedicle Graft
All areas; however, requires sufficient adjacent tissue – usually good for localized recession.
Preparation: After anesthesia, the roots of the affected teeth are thoroughly cleaned, and a recipient bed is created to receive the pedicle.
Creating the Pedicle: No tissue harvesting or allograft material needed. Instead, a flap of tissue (the pedicle) is partially cut from the gum near the receded area. This flap remains attached on one side, keeping its blood supply intact.
Repositioning the Tissue: The pedicle is then stretched and repositioned to cover the exposed root of the tooth and the recipient bed. The pedicle is secured with very small sutures.
Healing: Because the tissue maintains its original blood supply, it typically integrates well and heals quickly, promoting new, thickened gum growth over the receded area.
CHAO “Pinhole” Technique
All areas, especially if treating an entire arch or multiple teeth. This procedure is most predictable when there is recession but a reasonably adequate quantity and quality of gum tissue is present.
Preparation: After anesthesia, the roots of the affected teeth are thoroughly cleaned.
Creating the Pinhole: A tiny hole, or “pinhole,” is made in the gum tissue near the area of recession using a specialized set of periodontal instruments.
Repositioning the Gums: Through this pinhole, the doctor gently loosens the gum tissue and stretches it over the exposed roots of the teeth. Collagen strips are inserted through the pinhole to help stabilize the repositioned tissue and encourage healing. Small sutures are used to secure the tissue over the receded area.
Healing: As the tissues heal and the collagen resorbs, a slight increase in tissue thickness occurs and the roots are covered.
During the new patient consultation, our doctors will create a customized treatment plan based on your specific recession conditions. They may recommend one of the following techniques if they feel it will benefit your tissue health, and/or esthetics.
