Soft Tissue Grafting

Soft tissue grafts are recommended to stop gum recession and to prevent further dental problems. Soft tissue grafts can also improve the aesthetics of your gum line to improve your smile. Your gums can recede for a number of reasons such as aggressive tooth brushing and periodontal disease. Exposed tooth roots, as the result of gum recession, can make your teeth appear too long. The exposed roots can also be sensitive to cold or hot foods and liquids, and are more susceptible to cavities.

A soft tissue graft will repair the defect and help prevent additional recession and bone loss. Soft tissue grafts can be used to cover roots or develop gum tissue where absent due to excessive gingival recession. It may be impossible however, to guarantee 100% root coverage. The ability to cover the roots of teeth completely depends on many factors, some of which are beyond the control of the surgeon.

A soft tissue graft is similar to a tissue transplant: tissue can be taken from a donor site and placed over the exposed roots. This tissue can be either from your palate or from a tissue bank. The areas will be left to heal and will be reassessed by your periodontist within two weeks. During this time, a tissue covering may be placed over the donor and recipient site to protect the areas, and may fall off within a day or two.

There are several different types of soft tissue grafts. Some of the more common ones are connective tissue grafts (see figures 1a, 1b and 1c, 2a and 2b) and free gingival grafts (see figures 3a and 3b). Connective tissue grafts are better in providing more root coverage to the tooth than are free gingival grafts. Also, the final result of either graft will provide a different appearance. The free gingival grafts tend to appear more pink and bulky than the connective tissue grafts.

All soft tissue grafting clinical photos by Dr. Herman Thang DDS, FRCD(C)

Figure 1a: Pre-operative view showing severe recession.
Figure 1b: Photograph taken two weeks after surgery showing excellent healing.
Figure 1b: 2 month post-operative photograph revealing excellent root coverage and stability.
Figure 2a: Pre-operative view showing severe recession along three anterior teeth.
Figure 2b: Two week follow up following a connective tissue graft. Excellent healing at this early stage, showing a good band of attached keratinized tissue as well as good root coverage.
Figure 3a: Pretreatment view illustrating very thin tissue surrounding the 44 (first premolar tooth). Patient was planning to have a crown on this broken down tooth.
Figure 3b: A free gingival graft has thickened the tissue. Root coverage was not necessary in this case.
4a: before grafting
4b: after grafting
5a Before
5b After

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