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

Gingival grafting (Wikipedia)

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
ICD-9-CM24.2-24.3
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