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Gum treatment
Gingival graft
Gingival grafting can be performed to restore a sufficient amount of gum around the teeth or around exposed tooth root surfaces caused by gingival recession. The dental health professionals who are qualified for this type of transplant are general dentists (for simple cases) and periodontists (for more complex cases).
Several techniques are used to perform gum grafts:
- The free autogenous gingival graft: This is the oldest gingival graft technique. It involves taking the graft from the patient’s palate and relocating it where there is gingival recession. The result of this method is less aesthetic than that obtained with other methods. It is not recommended to use this type of grafting when the tooth roots should be covered because this technique only stops the progression of gingival recession minimally. However, the advantage of this technique is the absence of risk of graft rejection, because it is taken from the mouth of the patient.
- Connective tissue graft (root coverage grafting with connective tissue): This is a relatively new and versatile technique. The connective tissue is taken from under the gum surface of the patient’s palate and is inserted at the area of gum recession. Its main benefits are the very aesthetic results and the ability to cover exposed roots. With this type of transplant, the patient cannot reject the graft because it comes from tissue taken from his mouth.
- Allogeneic gum graft (allograft): this type of transplant is relatively recent. A graft from an external donor, who has been treated and is very safe, is located in the gingiva of another patient. The main advantage of an allograft is that there is only a single surgical site because the graft is not taken from the patient’s palate. It also gives results that are as aesthetic as the connective tissue graft. However, there is a low risk of transplant rejection.
The gum transplant success rate is very high. The beneficial effects of these grafts persist for many years although a little less for smokers.
Gingivectomy
Gingivectomy is a surgical procedure that involves removing a portion of the gingiva. It is performed under local anesthesia and does not usually cause any complications.
Recent techniques allow performing minor gingivectomies using a soft tissue laser, which causes much less discomfort and postoperative complications for the patient.
There are three main applications of the gingivectomy:
Aesthetic application
A gingivectomy allows to remove a part of the gum around one or several teeth in order to harmonize the shape of the gingiva and improve the smile.
Treatment of gingival hyperplasia
When the gums are enlarged in an unusual way and hide partly or completely a dental crown, a gingivectomy is recommended in order to remove the excess tissue. If the situation remains unchanged, the patient is exposed to a high risk of developing periodontitis. Gingival overgrowth may be due, among other factors, to medications known to generate a surplus of gingiva like drugs used to treat epilepsy and hypertension.
Periodontal treatment
Within the context of a periodontal treatment, a gingivectomy is used to cut a surplus of gingiva that is not attached to a tooth in order to clean a periodontal pocket that may have formed during gum disease. This cleaning procedure is also known as gingival curettage.
Gingivoplasty
The gingivoplasty is a minor surgical procedure designed to reshape the contour of the gums. It allows improving your smile by making it more attractive and harmonious. It is also a complement to a gingivectomy which, alone, would not give the best results.
The procedure is usually carried out by the same dental health professionals that perform gingivectomies (general dentists and periodontists). A local anesthesia is required to perform gingivoplasty and a soft tissue laser can be used. Complications are rare and post-operative discomfort is minimal.
The gingivoplasty is especially used in orthodontic treatment, to refine the aesthetics of the smile. In fact, when moving teeth with crowns of different lengths, the smile line may not be optimal because of uneven gums.
A dental health professional may also resort to gingivoplasty in the context of gum disease treatment. In this case, this technique can restore the gum to normal form after having treated the deformed, damaged or necrotic alveolar bone.
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