The Subepithelial Connective Tissue Graft
The ability to cover exposed teeth root surfaces has been a long-time objective of periodontists. Procedures now available will allow your periodontist to predicably achieve the root coverage you need. Even though gum recession does not always result in tooth loss, it is quite often associated with increased root sensitivity, an increase in root cavities, and tissue irritation that is perceived as an aesthetic impairment during your smile. It is beneficial that you are aware that these simple surgical periodontal treatments are both available and quite successful.
Gum Recession and Exposed Tooth Roots
The subepithelial connective tissue technique will be addressed after a review of the issues related to gum recession and root exposure.
The term mucogingival surgery, or gum tissue surgery, was first introduced into periodontics in the 1950s and was defined as a surgical procedure to preserve gum tissue, remove an abnormal frenulum, and correct muscle attachments to increase the depth of the vestibule. The definition has evolved to now refer to periodontal surgical procedures to correct issues and defects in the structure, position, and amount of gum tissue surrounding the teeth. The term periodontal plastic surgery procedure might be more appropriate since mucogingival surgery, or gum tissue surgery, now includes not only the treatment of problems dealing with the amount of gum recession defects but also includes correction of form and soft tissue aesthetics.
The gingivae, or gum tissue, is composed of connective tissue covered with dense and active cells and extends from the gingival margin to the mucogingival junction. The gum tissue is made up of three segments, a free segment, the part of the tissue that corresponds to the probing depth, and the attached segment, which is determined by subtracting the probing depth from the entire width of the tissue.
Different Versions of Gum Tissue Grafting
A variety of surgical procedures have been utilized for the augmentation of gingival tissues. These include:
- Free soft tissue grafts- Both epithelialized free gingival grafts, subepithelial connective tissue grafts.
- Rotational flaps- Laterally sliding flaps, papilla, and double papilla flaps.
- Coronally positioned flap- Flaps without rotation or lateral movement.
- Pedicle soft tissue graft- Uses a membrane with guided tissue regeneration.
The most common and frequently used plastic gum tissue surgery procedure today is the subepithelial connective tissue graft because it is high successful and predictable in achieving the desired root coverage. This procedure was introduced in 1985 and has been continued to be refined over the last few years. This restoration technique represents a substantial improvement over the free gingival graft for a variety of reasons:
- The Subepithelial Connective Tissue Graft leads to more predictable root coverage.
- It is a less traumatic surgery and has fewer and less severe post-operative complications through healing.
- It results in a superior aesthetic outcome which allows for totally natural tissue-color matching.
Before evaluating and considering the tissue grafting procedures, it is best to determine the classification of your gingival recession, or gum recession. This will help your periodontist choose the most appropriate treatment to deliver the highest level of success for you exposed root coverage.