Soft tissue grafting
A gum (gingival) graft is used to replace missing and / or receded gum tissue.
Types of gum tissue:
There are two types of gum tissue in the mouth, one of which surrounds the necks of the teeth and is thick and protective in nature (keratinized gingiva). The other of which lines our cheeks and floor of the mouth whose purpose is to be elastic and mobile in nature (mucosa).
Why is a gum graft needed?
Soft tissue grafts are used to replace missing thick tissue (keratinized gingiva), which has worn away from the necks of the teeth for a variety of reasons. The purpose of gum grafting is to minimize and/or arrest the progression of recession.
Unfortunately associated with every type of recession, there is bone loss, because the bone resides just beneath the gums. Therefore, if the gums have receded, then the bone too has receded. The purpose of gum grafting is to arrest the progression of recession and thereby halt the bone loss as well, by restoring a thick zone of protective tissue around the neck of the tooth / teeth which exhibits an absence of this thick keratinized gum tissue.
In certain instances it is not only possible to restore the missing keratinized (thick / protective) gum tissue, but also to cover the exposed root surface of the tooth / teeth in question. Other issues must be addressed as well, such as the biting forces being placed on the teeth.
Unbalanced forces placed on the teeth in the presence of clenching or grinding can predispose an individual to recession. Being a candidate for this root coverage procedure, which is achieved by a connective tissue graft, is to be determined by the doctor.
Cosmetic Gum Grafts:
Esthetic gum grafting can be used to “plump up” the gum tissue in an area that is deficient and would result an unaesthetic cosmetic make-over. Remember the teeth and gums should exhibit symmetry, yet sometimes one side is deficient, therefore, gum grafting may be essential to achieve symmetry prior to a cosmetic make-over.
What causes recession?
Aggressive brushing – potentially? Some people believe that aggressive brushing with a hard bristled brush may be a co-factor in recession or erosion of the neck of the tooth
Excessive biting forces – clenching and/or grinding? This can result in bending / flexing of teeth, which will often result in fracture of a small portion of tooth structure at the gum line (abfractions) and consequently bone and gum recession
Maloccluded and misaligned teeth? Teeth that positioned outside the normal arch form of the jaw are subject to having abnormal forces placed on them causing recession
Genetic Predispostion – Many patients are predisposed to having marginal or less than optimal oral tissue “bulk”. While no disease or health issue may exist, some patients can experience gum recession or thinning out of tissue for no apparent reason.
When treating recession by gum grafting, the causative factor must also be addressed in order for the grafting procedure to be successful.