Anatomy and Rationale
- Oral cavity has keratinized and nonkeratinized tissue
- Keratinized tissue surrounds teeth and is called gingiva
- Alveolar mucosa is nonkeratinized oral epithelium
- Nonkeratinized tissue lines cheeks, underside of tongue, and floor of mouth
- Lips contain both non-keratinized and keratinized tissue
- Gum grafting is a surgical procedure to reverse gum recession
- Gum recession exposes tooth roots, leading to sensitivity and increased risk of damage or disease
- Gum graft aims to extend keratinized tissue to cover tooth roots and restore firm placement within the jaw
- Prevents further damage to bone and keratinized tissue around the teeth
- Helps prevent tooth loss and maintain oral health
Options in Gum Grafting
- Traditional gum grafting harvests gums from the roof of the mouth
- Allografting techniques use tissue from cadavers for larger cases
- Considerations include limited quantity, morbidity, and risk of disease transmission
- Various grafting techniques available, such as autograft, allograft, xenograft, or repositioning of native tissue
- Benefits include decreased sensitivity and increased keratinized tissue
Advantages of APRF in Gum Grafting
- APRF (autologous platelet-rich fibrin) uses blood-derived growth factors for tissue regeneration
- Widely used in dentistry and oral surgery
- Advantages include unlimited amount of harvested blood, no risk of rejection or disease transmission, and high-quality healing
- Contains autogenous growth factors and stem cells
- Promotes gum fabrication and eliminates the need for other grafting techniques
Technique
- Small amount of blood is harvested and spun in a centrifuge
- Fibrin clot with growth factors, extracellular matrix, and stem cells is fabricated
- Clot is implanted into the gums above the area of gum recession
- Platelet-rich fibrin promotes gum growth and eliminates the need for other grafting sources
- Enhanced healing factors lead to improved recovery and reduced recovery time
Techniques for Guided Bone Reconstruction
- Grafting techniques enhance bone growth by preventing soft tissue ingrowth
- Resorbable and nonresorbable membranes are used in guided bone reconstruction
- Metallic membranes and membranes supported by a titanium frame have been successful
- The acellular dermal matrix has been used as a barrier membrane with bone allograft
- Micro-surgical procedures have made these techniques more predictable and comfortable for patients
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Gingival grafting, also called gum grafting or periodontal plastic surgery, is a generic term for the performance of any of a number of periodontal surgical procedures in which the gum tissue is grafted. The aim may be to cover exposed root surfaces or merely to augment the band of keratinized tissue.
| Gingival graft | |
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| ICD-9-CM | 24.2-24.3 |
