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Gum Graft Implants

Many dentists now realise that the gums are as important as the dental implant for long term success. Having a dental implant and restoration without addressing the gum quality with result in short time success, but in time, you will probably develop problems.

Thin gums area major cause of gum recession and can cause problems with dental implants too. You are born with a biotype and therefore given the thickness of your gums. When it comes to dental implants…the thicker the gum the better. This is also true for natural teeth. The presence of a soft tissue seal/cuff around dental implants and abutments and its role in defense against infection has been well researched and proven to be signficantly important.
Gum graft increases width of keratinised gingiva (Thick resistant type gum) and protects new implant crown margins to help prevent peri-implantitis (infection around dental implants resulting in bone loss and possible implant failure if cannot be corrected).

Gum graft surgery can be performed to improve the quality of your gums either prior to or at the same time as having dental implant placement.

Research studies have proven that thin, fragile gums have a major influence on the outcome of dental implants.
*When gums are thin, it becomes more transparent, the implant shows through the gums as a grey or grayish tint. This does not look good.
*Thin gums are not as tough and can be damaged more easily. The gums can recede causing the bone to recede too. If this happens, the threads of the implant can show. This becomes a long term issue.
*Exposed dental implant threads makes cleaning extremely difficult and can result in recurrent infection and the loss of the dental implant with it's restoration.

Three different types of gum tissue grafts are typically performed. Which type your dentist uses on you will depend on your specific needs. The graft procedures include:
* Connective-tissue grafts. This is the most common method used to treat root exposure. During the procedure, a flap of skin is incised at the roof of your mouth (palate) and tissue from under the flap, called subepithelial connective tissue, is gently removed and then sutured to the gum tissue surrounding the exposed root. After the connective tissue (the graft) has been removed from under the palatal flap, the flap is sutured back down.
* Free gingival graft. Similar to a connective-tissue graft, free gingival grafts involve the use of tissue from the roof of the mouth. But instead of making a flap and removing tissue under the top layer of palate, a small amount of tissue is removed directly from the roof of the mouth and then attached to the gum area being treated. This method is used most often in people who have thin gums to begin with and need additional tissue to enlarge the gums.
* Pedicle graft. In this procedure, instead of taking tissue from the palate, it is grafted from gum around or near the tooth needing repair. The flap, called a pedicle, is only partially cut away so that one edge remains attached. The gum is then pulled over or down to cover the exposed root and sutured into place. This procedure can only be done in people who have plenty of gum tissue near the tooth.

Although a low risk procedure, risks related to gingival grafting might include post-operative bleeding, swelling, pain, infection, facial discoloration, temporary or on occasion permanent tooth sensitivity to hot or cold or sweets or acidic foods. A temporary or permanent numbing of the surgical areas may occur on rare occasion. Risks related to the local anesthetics include but are not limited to allergic reactions, accidental swallowing of foreign matter, facial swelling or bruising, pain, soreness or discoloration at the site of injection of the local anesthetics.

Gum graft surgery is normally treated by retrieving soft tissue from the roof (palate) of your mouth. However, removing a section of your palate creates unnecessary pain and discomfort.
Mucograft and Alloderm RTM is alternative materials to your natural tissue.

AlloDerm® RTM is widely used in the medical and dental fields for plastic and reconstructive surgery. AlloDerm® RTM is donated tissue that has been processed to remove cells creating a regenerative tissue matrix. Its success in soft tissue treatments is documented by more than 10 years of dental applications and research. Donor tissue is extensively screened and tested and then undergoes proprietary processing to ensure that AlloDerm® RTM is ready for use in patients.

What is Geistlich Mucograft®?
*Device for soft-tissue regeneration: Geistlich Mucograft® is a 3D-matrix for soft-tissue regeneration in the oral cavity.
*Porcine collagen: The device is made of Swiss porcine collagen which will be replaced by your own soft-tissue cells during the regeneration process.
*Swiss quality materials: As an approved medical device, Geistlich Mucograft® fulfills highest standards for quality and safety.

What are your benefits with Geistlich Mucograft®?
*Less pain: Geistlich Mucograft® avoids the harvest of soft tissue from your palate. This, eliminates harvest site complications like pain or infections.
*Easier recovery: Eliminating the soft-tissue harvest from your palate allows an easier recovery and faster return to your normal lifestyle.
*Less surgical chair time: With Geistlich Mucograft® the surgical time is clearly reduced.
*Excellent soft-tissue healing: Geistlich Mucograft® naturally integrates into your own soft tissue without device related inflammation.
*Good match with surrounding tissue: The device promotes good colour and structure blend of the regenerated tissue.

Discuss your full medical history with your dental specialist. Patient results may vary. Recovery instructions can vary for each patient and will be provided by your dentist.

Why is gum thickness important?

Research studies have proven that thin, fragile gums have a major influence on the outcome of dental implants.
*When gums are thin, it becomes more transparent, the implant shows through the gums as a grey or grayish tint. This does not look good.
*Thin gums are not as tough and can be damaged more easily. The gums can recede causing the bone to recede too. If this happens, the threads of the implant can show. This becomes a long term issue.
*Exposed dental implant threads makes cleaning extremely difficult and can result in recurrent infection and the loss of the dental implant with it's restoration.

How is the surgery performed?

Three different types of gum tissue grafts are typically performed. Which type your dentist uses on you will depend on your specific needs. The graft procedures include:
* Connective-tissue grafts. This is the most common method used to treat root exposure. During the procedure, a flap of skin is incised at the roof of your mouth (palate) and tissue from under the flap, called subepithelial connective tissue, is gently removed and then sutured to the gum tissue surrounding the exposed root. After the connective tissue (the graft) has been removed from under the palatal flap, the flap is sutured back down.
* Free gingival graft. Similar to a connective-tissue graft, free gingival grafts involve the use of tissue from the roof of the mouth. But instead of making a flap and removing tissue under the top layer of palate, a small amount of tissue is removed directly from the roof of the mouth and then attached to the gum area being treated. This method is used most often in people who have thin gums to begin with and need additional tissue to enlarge the gums.
* Pedicle graft. In this procedure, instead of taking tissue from the palate, it is grafted from gum around or near the tooth needing repair. The flap, called a pedicle, is only partially cut away so that one edge remains attached. The gum is then pulled over or down to cover the exposed root and sutured into place. This procedure can only be done in people who have plenty of gum tissue near the tooth.

What are the Risks?

Although a low risk procedure, risks related to gingival grafting might include post-operative bleeding, swelling, pain, infection, facial discoloration, temporary or on occasion permanent tooth sensitivity to hot or cold or sweets or acidic foods. A temporary or permanent numbing of the surgical areas may occur on rare occasion. Risks related to the local anesthetics include but are not limited to allergic reactions, accidental swallowing of foreign matter, facial swelling or bruising, pain, soreness or discoloration at the site of injection of the local anesthetics.

What are the alternatives?

Gum graft surgery is normally treated by retrieving soft tissue from the roof (palate) of your mouth. However, removing a section of your palate creates unnecessary pain and discomfort.
Mucograft and Alloderm RTM is alternative materials to your natural tissue.

AlloDerm® RTM is widely used in the medical and dental fields for plastic and reconstructive surgery. AlloDerm® RTM is donated tissue that has been processed to remove cells creating a regenerative tissue matrix. Its success in soft tissue treatments is documented by more than 10 years of dental applications and research. Donor tissue is extensively screened and tested and then undergoes proprietary processing to ensure that AlloDerm® RTM is ready for use in patients.

What is Geistlich Mucograft®?
*Device for soft-tissue regeneration: Geistlich Mucograft® is a 3D-matrix for soft-tissue regeneration in the oral cavity.
*Porcine collagen: The device is made of Swiss porcine collagen which will be replaced by your own soft-tissue cells during the regeneration process.
*Swiss quality materials: As an approved medical device, Geistlich Mucograft® fulfills highest standards for quality and safety.

What are your benefits with Geistlich Mucograft®?
*Less pain: Geistlich Mucograft® avoids the harvest of soft tissue from your palate. This, eliminates harvest site complications like pain or infections.
*Easier recovery: Eliminating the soft-tissue harvest from your palate allows an easier recovery and faster return to your normal lifestyle.
*Less surgical chair time: With Geistlich Mucograft® the surgical time is clearly reduced.
*Excellent soft-tissue healing: Geistlich Mucograft® naturally integrates into your own soft tissue without device related inflammation.
*Good match with surrounding tissue: The device promotes good colour and structure blend of the regenerated tissue.

Discuss your full medical history with your dental specialist. Patient results may vary. Recovery instructions can vary for each patient and will be provided by your dentist.

Video Courtesy of SGDS

Frequently asked questions about Gum Graft Implants

  • Post-surgical care

    A few tips for post-surgical care:
    1. Treat swelling with damp-cold pads without pressing the pad.
    2. In case of pain your dentist will prescribe suitable medication.
    3. Avoid hot beverages, hot food and alcohol for 3 days after the procedure.
    4. For the first 4 weeks, no brushing or flossing at the gum line and no chewing of hard foods.
    5. 4–8 weeks after surgery, follow the oral hygiene instructions of your dentist (soft toothbrush).
    6. 8–12 weeks after surgery, begin with normal careful brushing.
    7. Smoking and inadequate oral hygiene can significantly reduce the success of the therapy or even lead to therapy failure.
    8. Keep your follow-up appointments with your dentist even if healing is proceeding without problems.

Still have questions?


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