Soft Tissue Grafting

When the roots of the teeth become exposed, eating hot and cold foods can be uncomfortable, decay is more prevalent, and the aesthetic appearance of the smile is altered.  The main goal of soft tissue grafting is to either cover the exposed root or to thicken the existing gum tissue in order to halt further tissue loss.

The three different types of common soft tissue grafts include:

• Free gingival graft – A strip of tissue is removed from the roof of the mouth and stitched to the grafting site in order to promote natural growth.  This type of graft is most commonly used for thickening existing tissue.
• Connective tissue graft – For larger areas or root exposure, subepithelial tissue is needed to remedy the problem.  This subepithelial connective tissue is removed from a small flap in the mouth and sutured to the grafting site.  This is the most common treatment for root exposure.
• Pedicle graft – This type of graft involves the “sharing” of soft tissue between the affected site and adjacent gum.  A flap of tissue is partially cut away and moved sideways to cover the root.  The results of this type of graft are excellent because the tissue that is moved to the adjacent area includes blood vessels that are left in place.

Initially, deep cleaning will be performed both above and below the gum line to clear the teeth and roots of calculus (tartar).  The grafting procedure itself will generally be performed under local anesthetic, but this will depend on the size of the areas receiving grafts.  A small incision will be made at the recipient site in order to create a small pocket.  A split thickness incision is made in this pocket, and the donor tissue is placed between the two sections of this area.  The donor tissue strip is generally larger than the incision, so some excess will be apparent.

Platelet-rich growth factors which stimulate natural tissue growth and promote good healing may be applied to the site before suturing.  In addition, tissue-stimulating proteins may be added to encourage quicker tissue growth.  Finally, the wound site will be sutured to prevent shifting, and surgical material will be placed to protect the sensitive area.  Gum uniformity and substantial healing will take place in the first six weeks after the procedure.