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GingivalGraftingWHAT IS INVOLVED IN THEGUM GRAFTING PROCESS?The procedure lasts 45-90 minutesdepending on the extent of graftingnecessary. It requires only localanesthesia (“Novocaine”), although oral orIV sedation are available for anxiouspatients. Sutures will be placed in yourpalate and at the grafted area. Themajority of patients control anydiscomfort with ibuprofen (Advil) oracetaminophen (Tylenol). The level ofsoreness resembles a pizza burn for mostpeople. It is possible to eat normallybefore and after the procedure. Mostpeople return to normal activities,including work, the next day.The grafted area will blend normally withthe teeth and gum tissue around it. Inmany cases exposed roots will becovered and look as though therecession had never happened. Thelikelihood and amount of root coveragecan be predicted at your consultation. Ifyou are careful not to overbrush, youshould not need the grafting proceduredone again in the future.Before CTGAfter CTGSeacoast Periodontics & Dental Implants185 Cottage Street, Suite 2Portsmouth, NH 03801(603) 294-0110www.rosaniadmd.com

The primary purpose of gingival grafting isto prevent continuing gum recession andto cover exposed roots when possible. Alack of well-attached gum tissue around atooth predisposes you to gum recession.When gum tissue recedes, the exposedroots have a high risk for decay since theyare not covered by enamel. In addition,roots may become sensitive to hot or coldfood or toothbrushing, and adversecosmetic changes occur. Progressive lossof attached gum tissue can cause guminfections which can lead to loss of teeth.Sometimes, teeth that will have a crownplaced or orthodontic treatment need agraft placed beforehand. WHAT IS A GINGIVAL (GUM)GRAFT AND WHY DO I NEED IT?Before CTGAfter CTGThe earliest gum augmentation technique,called a free gingival graft (FGG), removedtissue from the surface of the palate andsutured it around teeth that were at risk forongoing recession. Unfortunately, thepalatal wound was painful and requiredweeks to heal. In addition, the gum tissueat the grafted area rarely matched theappearance of the natural gum tissuearound it, and the FGG rarely succeeded incovering exposed roots where recessionhad occurred. Due to pain andcompromised esthetic results, it is rarelyused today.As an alternative to CTGs, sterilizedcadaver tissue (acellular dermal matrix;ADM) can be used for soft tissue grafting.ADM allows for treating many teeth in onevisit and is usually reserved for patientswho need multiple areas grafted. ADMeliminates the need for using palataltissue, but the result is slightly less idealthan the CTG. SURGICAL TECHNIQUESIt is important to understand why you needa gingival graft in order to achieve the besttreatment result and to avoid the need formore grafting in the future. Possible causesof gum recession include excessivetoothbrushing force and/or brushing morethan twice daily; smoking; malpositionedteeth; pulling from a lip or cheek muscle(frenum); clenching or grinding teeth; andperiodontal (gum) disease.Studies have shown that recession of 2-3millimeters or more nearly alwaysworsens over time. Grafting at the earlystage of recession achieves morepredictable results than waiting until therecession becomes severe.WHY DID THIS HAPPEN TO ME?Before CTGAfter CTGCurrently, the ideal approach for gingivalgrafting is a Subepithelial ConnectiveTissue Graft (CTG). Unlike FGGs, CTGs liftopen a small pouch in the palate so thedonor tissue can be removed. The pouch issutured closed to avoid a painful openwound. The graft tissue is sutured intoanother pouch, or tunnel, around the teethwith recession and weak gum tissue. CTGs are much less invasive, cause littlepain and provide superior esthetic results.CTGs allow for a natural appearance andincrease the chances for covering exposedroots. The limitation of the CTG is that itonly provides enough tissue for grafting ofa few teeth at one time.Before FGGAfter FGG

The primary purpose of gingival grafting isto prevent continuing gum recession andto cover exposed roots when possible. Alack of well-attached gum tissue around atooth predisposes you to gum recession.When gum tissue recedes, the exposedroots have a high risk for decay since theyare not covered by enamel. In addition,roots may become sensitive to hot or coldfood or toothbrushing, and adversecosmetic changes occur. Progressive lossof attached gum tissue can cause guminfections which can lead to loss of teeth.Sometimes, teeth that will have a crownplaced or orthodontic treatment need agraft placed beforehand. WHAT IS A GINGIVAL (GUM)GRAFT AND WHY DO I NEED IT?Before CTGAfter CTGThe earliest gum augmentation technique,called a free gingival graft (FGG), removedtissue from the surface of the palate andsutured it around teeth that were at risk forongoing recession. Unfortunately, thepalatal wound was painful and requiredweeks to heal. In addition, the gum tissueat the grafted area rarely matched theappearance of the natural gum tissuearound it, and the FGG rarely succeeded incovering exposed roots where recessionhad occurred. Due to pain andcompromised esthetic results, it is rarelyused today.As an alternative to CTGs, sterilizedcadaver tissue (acellular dermal matrix;ADM) can be used for soft tissue grafting.ADM allows for treating many teeth in onevisit and is usually reserved for patientswho need multiple areas grafted. ADMeliminates the need for using palataltissue, but the result is slightly less idealthan the CTG. SURGICAL TECHNIQUESIt is important to understand why you needa gingival graft in order to achieve the besttreatment result and to avoid the need formore grafting in the future. Possible causesof gum recession include excessivetoothbrushing force and/or brushing morethan twice daily; smoking; malpositionedteeth; pulling from a lip or cheek muscle(frenum); clenching or grinding teeth; andperiodontal (gum) disease.Studies have shown that recession of 2-3millimeters or more nearly alwaysworsens over time. Grafting at the earlystage of recession achieves morepredictable results than waiting until therecession becomes severe.WHY DID THIS HAPPEN TO ME?Before CTGAfter CTGCurrently, the ideal approach for gingivalgrafting is a Subepithelial ConnectiveTissue Graft (CTG). Unlike FGGs, CTGs liftopen a small pouch in the palate so thedonor tissue can be removed. The pouch issutured closed to avoid a painful openwound. The graft tissue is sutured intoanother pouch, or tunnel, around the teethwith recession and weak gum tissue. CTGs are much less invasive, cause littlepain and provide superior esthetic results.CTGs allow for a natural appearance andincrease the chances for covering exposedroots. The limitation of the CTG is that itonly provides enough tissue for grafting ofa few teeth at one time.Before FGGAfter FGG

The primary purpose of gingival grafting isto prevent continuing gum recession andto cover exposed roots when possible. Alack of well-attached gum tissue around atooth predisposes you to gum recession.When gum tissue recedes, the exposedroots have a high risk for decay since theyare not covered by enamel. In addition,roots may become sensitive to hot or coldfood or toothbrushing, and adversecosmetic changes occur. Progressive lossof attached gum tissue can cause guminfections which can lead to loss of teeth.Sometimes, teeth that will have a crownplaced or orthodontic treatment need agraft placed beforehand. WHAT IS A GINGIVAL (GUM)GRAFT AND WHY DO I NEED IT?Before CTGAfter CTGThe earliest gum augmentation technique,called a free gingival graft (FGG), removedtissue from the surface of the palate andsutured it around teeth that were at risk forongoing recession. Unfortunately, thepalatal wound was painful and requiredweeks to heal. In addition, the gum tissueat the grafted area rarely matched theappearance of the natural gum tissuearound it, and the FGG rarely succeeded incovering exposed roots where recessionhad occurred. Due to pain andcompromised esthetic results, it is rarelyused today.As an alternative to CTGs, sterilizedcadaver tissue (acellular dermal matrix;ADM) can be used for soft tissue grafting.ADM allows for treating many teeth in onevisit and is usually reserved for patientswho need multiple areas grafted. ADMeliminates the need for using palataltissue, but the result is slightly less idealthan the CTG. SURGICAL TECHNIQUESIt is important to understand why you needa gingival graft in order to achieve the besttreatment result and to avoid the need formore grafting in the future. Possible causesof gum recession include excessivetoothbrushing force and/or brushing morethan twice daily; smoking; malpositionedteeth; pulling from a lip or cheek muscle(frenum); clenching or grinding teeth; andperiodontal (gum) disease.Studies have shown that recession of 2-3millimeters or more nearly alwaysworsens over time. Grafting at the earlystage of recession achieves morepredictable results than waiting until therecession becomes severe.WHY DID THIS HAPPEN TO ME?Before CTGAfter CTGCurrently, the ideal approach for gingivalgrafting is a Subepithelial ConnectiveTissue Graft (CTG). Unlike FGGs, CTGs liftopen a small pouch in the palate so thedonor tissue can be removed. The pouch issutured closed to avoid a painful openwound. The graft tissue is sutured intoanother pouch, or tunnel, around the teethwith recession and weak gum tissue. CTGs are much less invasive, cause littlepain and provide superior esthetic results.CTGs allow for a natural appearance andincrease the chances for covering exposedroots. The limitation of the CTG is that itonly provides enough tissue for grafting ofa few teeth at one time.Before FGGAfter FGG

GingivalGraftingWHAT IS INVOLVED IN THEGUM GRAFTING PROCESS?The procedure lasts 45-90 minutesdepending on the extent of graftingnecessary. It requires only localanesthesia (“Novocaine”), although oral orIV sedation are available for anxiouspatients. Sutures will be placed in yourpalate and at the grafted area. Themajority of patients control anydiscomfort with ibuprofen (Advil) oracetaminophen (Tylenol). The level ofsoreness resembles a pizza burn for mostpeople. It is possible to eat normallybefore and after the procedure. Mostpeople return to normal activities,including work, the next day.The grafted area will blend normally withthe teeth and gum tissue around it. Inmany cases exposed roots will becovered and look as though therecession had never happened. Thelikelihood and amount of root coveragecan be predicted at your consultation. Ifyou are careful not to overbrush, youshould not need the grafting proceduredone again in the future.Before CTGAfter CTGSeacoast Periodontics & Dental Implants185 Cottage Street, Suite 2Portsmouth, NH 03801(603) 294-0110www.rosaniadmd.com

GingivalGraftingWHAT IS INVOLVED IN THEGUM GRAFTING PROCESS?The procedure lasts 45-90 minutesdepending on the extent of graftingnecessary. It requires only localanesthesia (“Novocaine”), although oral orIV sedation are available for anxiouspatients. Sutures will be placed in yourpalate and at the grafted area. Themajority of patients control anydiscomfort with ibuprofen (Advil) oracetaminophen (Tylenol). The level ofsoreness resembles a pizza burn for mostpeople. It is possible to eat normallybefore and after the procedure. Mostpeople return to normal activities,including work, the next day.The grafted area will blend normally withthe teeth and gum tissue around it. Inmany cases exposed roots will becovered and look as though therecession had never happened. Thelikelihood and amount of root coveragecan be predicted at your consultation. Ifyou are careful not to overbrush, youshould not need the grafting proceduredone again in the future.Before CTGAfter CTGSeacoast Periodontics & Dental Implants185 Cottage Street, Suite 2Portsmouth, NH 03801(603) 294-0110www.rosaniadmd.com