In the first part of my blog post on gum grafting, I shared about the causes of gum recession, consequences of gum recession and the types of gum grafting surgical procedures available. In the second part, I will go on to share the types of grafts used during gum grafting and common risks.
Types of grafts
What do we use for gum grafting? Well, grafts can be taken from the patient (autogenous), and these are usually from the roof of the mouth. This region heals extremely well with minimal scarring and is also cosmetically hidden.
Autogenous grafts remain the current gold standard. Decades of extensive clinical research have proven their superior clinical efficacy.
Alternatively, grafts can also be from collagen based substitutes (eg. Mucograft, FibroGuide). This reduces patient discomfort/complications from one less surgical site and there is also an unlimited supply. These substitutes however are relatively new and hence there are fewer research on their clinical efficacy.
Common risks of gum grafting
The common risks of gum grafting include pain, bleeding, swelling, infection and necrosis of the graft leading to only partial augmentation or complete failure.
In conclusion, here are 10 things you need to know about gum grafting:
- Treating gum recession first involves identifying the underlying cause(s) and a period of stabilisation.
- This usually involves initial courses of professional gum cleaning, oral hygiene instructions and monitoring.
- If the underlying precipitating or predisposing factor(s) are not stabilised then gum recession will likely continue even after gum grafting, which eventually leads to failure.
- The choice of gum grafting technique will depend on the specific clinical scenario and goals of treatment.
- Gum grafting is very technique and healing sensitive but if correctly planned, it can work extremely well.
- Common risks of gum grafting procedures include graft necrosis leading to only partial augmentation or complete failure of the graft.
- In general, the more severe the gum recession the more likely gum grafting will be beneficial in attaining a noticeable result that is satisfactory to the patient (even if only partial).
- The more minor the recession, the more unlikely gum grafting will be beneficial in attaining a noticeable result satisfactory to the patient (and may even risk making things worse).
- Loss of inter-dental gum (dark triangles) are the most difficult to treat and a multidisciplinary approach may be required.
- Managing expectations is extremely important in gum grafting surgery.
Dr Ben Wang is a dental surgeon with postgraduate training in Periodontics. This is a dental specialty that involves the prevention, diagnosis, treatment of gum diseases and the placement of dental implants. Dr Wang received his basic dental training from the University of London, where he also attained an honours degree in Microbiology. He then worked in the private dental sector and hospital dentistry prior to embarking on a three-year full-time Periodontics training program at the Eastman Dental Institute treating patients with a wide range of complex gum diseases. He has completed his examinations with the Royal College of Surgeons of Edinburgh. Dr Wang has interests in the critical appraisal of research, all aspects of gum surgery, bone and soft tissue graft around teeth and implants.