Soft Tissue Grafting
The loss of the foundation of the teeth can be seen in a number of ways. One is through periodontal pocketing or, if the gum tissue is thin, you can begin to see the roots of the teeth. When recession of the gum tissue occurs, the body loses a natural defense against both bacterial penetration and trauma. When gum recession is a problem, gum reconstruction using grafting techniques is an option.
When there is only minor recession, some healthy gingiva often remains and protects the tooth, so that no treatment other than modifying home care practices is necessary. In this scenario, the gum still provides an effective seal against the continuous attack of bacteria on your jawbone. However, when recession has eliminated the effective seal, the first line of defense against bacterial penetration is lost.
In addition, gum recession often results in root sensitivity to hot and cold foods as well as an unsightly appearance of the gum and tooth. Significant gum recession can predispose to worsening recession and expose the root surface, which is softer than enamel, leading to root decay and root erosion.
A gingival (or gum) graft is designed to solve these problems. A thin piece of tissue may be taken from the roof of the mouth or gently moved over from adjacent areas to provide a stable band of healthy gingiva around the tooth. The gingival graft may be placed in such a way as to cover the exposed portion of the root.
The gingival graft procedure is highly predictable and results in a stable healthy seal around the tooth.
Guided Tissue Regeneration
The traditional and effective way to treat periodontal disease involves reshaping gums and jawbone to reduce pocket depth.
In some situations, bone can be made to re-grow by a procedure called Guided Tissue Regeneration (GTR). This is optimal treatment, but can only be applied in limited situations. The key to predictability is careful case selection. Many times, determining whether a guided tissue regeneration is possible can only be done at the time of surgery. A new technology, the cone beam CT scan, has greatly improved our ability to assess the shape, size and extent of bone loss areas. This allows us to predict the feasibility of GTR with greater accuracy.
The GTR procedure is often accomplished in combination with a bone graft. GTR involves the placement of a barrier over the lost bone area. The barrier effectively separates the soft tissue from the bone, thereby creating space for bone to grow. GTR products come in resorbable and non-resorbable materials. The non-resorbeable materials require a second procedure for removal of the GTR barrier.