Civitali Dental and Prosthetic Center srl

Free Gingival graft from the palate at the superior canine

 

A good gingival quality is fundamental for teeth health and stability. An attached gingival band around the tooth is necessary to provide periodontal and dental health and to preserve both over time.


Each individual has his/her own qualitative and quantitative characteristic as far as the gingiva is concerned, according to his/her hereditary traits. Some people show a high amount of gingival tissue (thick and flat biotype) while others, on the contrary, display a minimum quantity only (thin and scalloped biotype).


Dental and periodontal assessment is, therefore, of paramount importance to classify the biotype properly, in order to know the patient’s hereditary tendencies and to prevent bad habits or behaviors leading to gingival recession.


Gingival recession is a condition where gingival margin is observed to lower and migrate towards the dental root. Such migration causes the uncovering of the root, which becomes visible creating aesthetic problems, hypersensitivity to thermal or sour stimulations, and possible abrasion and erosion.


Over time, recession may cause complications compromising severely the integrity of the tooth-supporting tissue complex. Recession may affect one or more dental elements. Causes leading to gingival recession insurgence are many. Among these some primary causes and some co-causes may be listed.


Wrong brushing technique, inadequate brush type

Inflammation of the gingival rim, caused by the presence of plaque and tartar

Bad teeth position or occlusion trauma

Bad habits (i.e. sucking objects like pens, pencils…)

Iatrogenic causes (badly performed fillings, prostheses, hooks, orthodontic bands…)

Some viral pathologies


The gingival biotype and the position of the tooth may predispose heavily to the formation of a recession. Prevention is, therefore, fundamental mainly in patients showing predisposing factors.


Therapy

Aimed to the causes

Aims to eliminate the factors causing the recession and in correcting any co-factor or anatomical alteration, if present.


Surgical

Only after eliminate the cause or causes of the recession, surgical treatment may be performed. Surgery is the only option that can restore the lost gingiva. Among the many approaches described in literature, the case shown in this page was treated by connective tissue grafting. It’s a technique that can be applied in many circumstances and has a good success rate, both immediately and over time. It is performed by collecting a piece of connective tissue from the palate and grafting it in the zone affected by recession. The palate heals rapidly with no complications. Such method maximizes also the aesthetic outcome, making the added gingiva nearly undistinguishable from the surrounding one.


Pre-surgical situation. The canine is affected by gingival recession

Probing shows the recession measures about 4 mm


Collection

The collected tissue


The seat of collection before suturing


Assessment of the graft size

Incision at the grafting site


The graft is placed into position

Graft is sutured


Incision of the palate and connective tissue collection

Suture removal after 7 days


Graft healing after 40 days