FREE GINGIVAL GRAFTING

Gingival recession is defined as a mucogingival deformity and condition that results in exposure of root surface. The main consequences of gingival recession include: 

• Root sensitivity
• Esthetic concerns
• Loss of periodontal support
• Increased risk of root decay

If your periodontist has decided that you have no protective zone of attached tissue beneath the root structure, a free gingival graft will be treatment planned. 

A free gingival graft is a thin piece of tissue taken from the roof of your mouth to be placed beneath the area of recession. The purpose is to thicken the underlying thin tissue and to prevent future recession.

• Approximately 1 hour of surgical time with the use of a local anesthetic. 
• First, the surgical site is prepared beneath the area of recession called a "bed prep." The overlying thin mucosal tissue is removed to create a blood supply.
• Then, a thin piece of tissue (free gingival graft) is taken from the palate (roof of the mouth) and a double-layer collagen dressing is placed with the use of an adhesive fibrin glue.
• Finally, the free gingival graft is perfectly contoured to fit within the bed beneath the root and sutured in place with resorbable stitches.
• You will return for a post-operative visit in two weeks to check on healing and reinstruct oral hygiene. 

Approximately 2-3 days. Every patient differs on level of discomfort depending on the extent of the graft site. 

The photo above shows gingival recession with thin tissue and no protective zone of attached tissue below the root structure. The lip is directly attached to the roots and recession will continue to progress if no treatment is performed. 

A free gingival graft has been placed below the exposed root structure to provide thickness and added protection from future recession.

A naturally occurring muscle attachment normally seen between the front teeth (upper or lower) is called a frenum. Any combination of thin tissue,  lack of attached tissue, or muscle pull may cause gingival recession to occur. A large frenum may even prevent teeth from joining harmoniously together. A frenectomy is removal and release of this muscle attachment in order to assist in avoiding future recession and gaps between teeth.

• 15-30 minutes with the use of a local anesthetic.
• The surgical release is either performed with a small incision or the use of a laser. Your periodontist will decide which treatment option is best for you. 
• A post-operative visit will be scheduled at two weeks post-frenectomy to observe the healing and reinstruct oral hygiene.

Approximately 1 day. 

The frenum (or muscle) attachment has created a separation (or diastema) between the front teeth.

The frenum attachment has been removed and braces placed. 

The braces have been removed and diastema is now closed with the muscle no longer impinging on teeth.