A gum graft is a common dental procedure designed to restore gum tissue that has receded or worn away. This procedure aims to cover exposed tooth roots, which can help reduce tooth sensitivity and protect against further gum recession and potential tooth decay. Beyond health benefits, gum grafts can also improve the appearance of the gum line, contributing to a more balanced smile.
Grafts From Your Own Body
Gum grafting often involves using tissue taken directly from the patient’s own mouth, known as an autogenous graft. This method often utilizes the palate as the donor site due to its readily available and suitable tissue. Three primary types of autogenous grafts are commonly employed, each with a specific method of tissue acquisition.
The connective tissue graft is the most frequently performed type. A flap is created on the roof of the mouth, and tissue from beneath its surface is removed. This subepithelial connective tissue, rich in collagen, is then placed at the site of gum recession and sutured into position. The original palatal flap is then repositioned and sutured back to cover the donor site, allowing for healing. This technique is preferred for its aesthetic outcomes and predictable results in covering exposed roots.
A free gingival graft involves taking a small, thin piece of tissue directly from the surface layer of the palate. Unlike the connective tissue graft, this procedure removes both the epithelial and connective tissue layers from the donor site. The harvested tissue is then placed and secured over the area requiring additional gum coverage. This type of graft is effective for increasing the amount of thick, durable gum tissue around teeth, to prevent future recession.
Another method is the pedicle graft, unique because the gum tissue remains partially attached to its original blood supply. This graft involves moving gum tissue from an area immediately adjacent to the recessed site. The tissue is loosened and rotated or slid over to cover the exposed root, maintaining a connection to its blood vessels. This technique is used when there is sufficient healthy gum tissue directly next to the area needing coverage, promoting good healing due to the preserved blood supply.
Grafts From Donated Human Tissue
When using a patient’s own tissue is not feasible or preferred, donated human tissue offers an effective alternative for gum grafting procedures. These materials, known as allografts, are sourced from screened cadaveric donors. The tissue undergoes extensive processing in specialized tissue banks to ensure its safety and sterility before it can be used for transplantation.
A common type of allograft used in dentistry is acellular dermal matrix, derived from donated human skin. During processing, all cellular components are removed, leaving only the extracellular matrix, which primarily consists of collagen and elastin. This acellular matrix provides a scaffold that the patient’s own cells can integrate, facilitating regeneration of gum tissue. The rigorous processing steps eliminate the risk of disease transmission and reduce the likelihood of immune rejection response.
Using donated human tissue eliminates the need for a second surgical site in the patient’s mouth, which significantly reduces post-operative discomfort. The availability of these processed tissues provides a convenient and preferred option for both patients and clinicians. This approach allows for the treatment of multiple areas of recession in a single procedure without concerns about the limited availability of tissue from the patient’s own palate.
Healing and Care for Donor Areas
The recovery process for the donor site is an important consideration when gum tissue is taken from the patient’s own body. Following an autogenous gum graft, the area where the tissue was harvested, typically the palate, will require specific care to heal properly. Patients can expect some soreness and discomfort at the donor site for approximately one to three weeks after the procedure. This discomfort is often managed with over-the-counter pain relievers or prescription medication, as advised by the dental professional.
During the initial healing phase, it is advisable to consume a soft diet to avoid irritating the sensitive donor area. Patients are generally instructed to avoid hot, spicy, or crunchy foods that could dislodge dressings or cause pain. Oral hygiene in the donor area should be performed gently, often with a prescribed antimicrobial mouthwash, to prevent infection and promote healing. Swelling and minor bleeding are common in the first few days but subside quickly.
For free gingival grafts, the donor site on the palate heals by secondary intention, meaning it forms new tissue from the bottom up. This process can sometimes lead to a longer or more noticeable healing period compared to the connective tissue graft donor site, which is often covered by a repositioned flap.