Gingival Graft

Gingival grafting is the procedure where a gingival graft, or gum graft, is placed in an area of exposed tooth root. This is done to cover the exposed portion of the root. The gingival graft is normally taken from the hard palate. This is one of the best ways to treat a receding gum line. It helps to prevent root caries, prevent hypersensitivity, and greatly improves aesthetics. However, there are specific indications for a gingival graft surgery which depends on many factors.

Types of Gingival Grafting Procedures

Free Gingival Graft
A free gingival graft is a procedure where a layer of tissue is removed from the hard palate of the patient's mouth and then is relocated to the site of the receding gums. The graft is then stitched into place and will help to protect the exposed root. The donor site eventually heals without any damage. This procedure is used to increase the thickness of the gums and hence, is used in cases where the gum tissue is very thin.

Subepithelial Connective Tissue Graft
This kind of a gingival grafting periodontal plastic surgery involves taking tissue from the layer under the healthy gum tissue of the palate which is then placed at the site of gum recession. The advantage of this procedure is that there is excellent predictability of root coverage as the gingival graft healing process is quicker in such types of surgeries. This is also a relatively painless procedure compared to a free gingival graft. This procedure is quite popular for covering exposed roots in cases of 'long tooth syndrome', that is, in cases where there is gum recession in relation with only one tooth.

Acellular Dermal Matrix
Such a gingival graft surgery involves using graft donated from medically processed human skin tissue. Although in this procedure, there is no need to get tissue from the hard palate, however, many periodontists believe that this procedure has a lower success rate. This is because they claim that a relatively foreign tissue may not be accepted that easily. However, others believe that the success rate of doing a gingival graft surgery using this graft is the same as that using a subepithelial connective tissue graft, although the gingival graft recovery may take longer.

Pedicle Graft
Also known as a lateral pedicle graft, in this procedure, gum tissue is taken from the area adjacent to the damaged gingiva. However, this is not always an option as there must be a sufficient amount of healthy gingival tissue present near the adjacent tooth. In this procedure, the healthy tissue is cut and rotated in its place to cover the damaged and receded region. However, the risk associated with this procedure is that even the donor region may land up with gum recession if the procedure fails.

Coronally or Apically Positioned Flaps
In this procedure, there is no graft that is cut and placed from a different region. However, the gingiva in opened and thoroughly cleaned and then either positioned coronally, that is towards the crown of the tooth, or apically, that is near the root of the tooth. This is done to clean up the region and prevent the gum disease from causing any further recession and damage to the gums. However, for this procedure, there needs to be adequate thickness and width of gingival tissue present at the base of the recession defect.

This was all about gum grafting types. The type of gingival graft procedure done will vary from person to person, depending on the dental health and the type of gum recession present. The gingival graft cost varies greatly and could be anywhere between USD 600 - 1000 depending on the type of surgery performed, complications involved and the kind of aftercare required. In the end, by taking adequate amount of dental care and by visiting the dentist regularly, one can prevent gum recession from taking place.