The Subepithelial Connective Tissue Graft
The capability to cover exposed tooth root surfaces has been an ongoing objective of oral surgeons. Procedures available now allow your surgeon to predictably restore and achieve the root coverage you need. Even though gum recession does not always cause tooth loss, it is often associated with increased root sensitivity, an increase in cavities, and tissue irritation that is perceived as an aesthetic abnormality in your smile. It is beneficial for you to be aware that these simple surgical periodontal treatments are available and quite successful.
Gum Recession and Exposed Tooth Roots
The subepithelial connective tissue technique will be described after a brief review of the issues related to gum recession and root exposure.
Gum tissue surgery was first introduced into dentistry in the 1950s and was described as a surgical procedure to preserve gum tissue, remove an abnormal frenulum, or correct muscle attachments to increase the depth of the vestibule. The definition now transformed to refer to periodontal surgical procedures for the intent of correcting issues and defects in the structure, amount, and position of gum tissue surrounding the teeth. The term periodontal plastic surgery procedure may be more appropriate since gum tissue surgery now includes not only the treatment of issues stemming from the amount of gum recession defects, but also includes correction of form and soft tissue aesthetics.
Your gum tissue, or gingivae, is composed of connective tissue covered with dense and active cells and extends from your gingival margin to the mucogingival junction. The gum tissue is composed of three segments: a free segment, next to the part of the tissue that corresponds to the probing depth, and finally the attached segment, which is determined by subtracting the probing depth from the entire width of the tissue.
Different Versions of Gum Tissue Grafting
Several different surgical procedures are successfully utilized for the augmentation of gingival tissues. These include:
- Free soft tissue grafts- Both epithelialized free gingival grafts and subepithelial connective tissue grafts.
- Rotational flaps- Laterally sliding flaps, papilla, and double papilla flaps.
- Coronally positioned flap- Flaps without rotation or lateral movement.
- Pedicle soft tissue graft- Uses a membrane with guided tissue regeneration.
The most frequent and commonly performed plastic gum tissue surgery procedure today is the subepithelial connective tissue graft because it is extraordinarily successful and predictable in achieving the desired root coverage. This procedure was introduced in 1985 and has continued to be refined over the last few decades. This restoration technique represents a substantial improvement over the free gingival graft for a variety of reasons:
- The Subepithelial Connective Tissue Graft leads to more predictable and controlled root coverage.
- It is a far less traumatic surgery and has fewer and less severe post-operative complications during healing.
- It results in a superior aesthetic outcome, which allows for totally natural tissue-color matching.
Before considering and evaluating the tissue grafting procedure options, it is best for your dental team to determine the classification of your gingival recession, or gum recession. This will help them choose the most appropriate treatment to deliver the highest level of success for your exposed root coverage.
Related Article: What is a Periodontics CTG?