“Gum” Soft Tissue Grafting
Gingival tissue grafting represents one of the most predictable and effective treatments in periodontal therapy, helping to restore both the health and aesthetics of your smile when gum recession threatens tooth stability and appearance.
These specialized procedures not only protect exposed tooth roots from bacterial infection but also create a stronger, more resilient gum line that can better withstand the daily challenges of oral hygiene and normal function.
Two primary grafting techniques: connective tissue grafts (CTG) and free gingival grafts (FGG). While CTG excels in cosmetic areas where seamless integration and natural appearance are paramount, FGG is ideal for building substantial amounts of protective keratinized tissue/mucosa in areas requiring enhanced durability and function.
The following clinical photographs demonstrate the remarkable healing potential and long-term success these procedures offer, showcasing real patient outcomes that highlight the transformative impact of expertly performed gingival grafting.
FGG case on an edentulous space
The patient completed orthodontic treatment before planned dental implant placement. The images show pre-operative, 2-week, and 4-week post-operative healing stages. Patients should expect normal healing responses including tissue inflammation, limited brushing ability with associated plaque accumulation, and tissue blanching at 2 weeks, provided post-operative instructions are followed carefully. The 4-week follow-up demonstrates excellent tissue integration and color blending that free gingival grafts can achieve similar to CTG.
FGG case on dental implant site
A healthy dental implant environment requires adequate keratinized mucosa, similar to the keratinized tissue surrounding natural teeth. Soft tissue grafting can be performed before, during, or after implant placement depending on clinical needs. In this case, grafting was completed during the second-stage implant surgery, simultaneously augmenting keratinized tissue around both the implant site and the adjacent premolar.
FGG on natural teeth
A successful FGG was performed on natural teeth. The primary objective of this FGG was to regenerate the gingival architecture that the patient had previously lost, especially on #20 and 21, rather than focusing on root coverage. The 3-week follow-up reveals excellent healing with notable improvements in keratinized tissue width and gingival thickness. The temporary tooth staining visible in the post-operative period resulted from prescribed Chlorhexidine mouthrinse use and will be easily addressed during routine periodontal maintenance appointments.
Various techniques can be employed at the donor site following graft harvesting to optimize hemostasis, enhance healing, and improve patient comfort. These may include sutures, collagen membranes, cyanoacrylate adhesives, and/or periodontal dressings. In this case, a collagen membrane was placed in combination with sutures to achieve effective hemostasis, as demonstrated in the clinical photograph. Post-surgery, periodontal dressing was placed. The accompanying images document normal healing progression at the 2-week postoperative mark.
CTG on natural teeth
This case showcases a CTG procedure. The preoperative condition presented a thin periodontal phenotype, which was successfully converted to a thick periodontal phenotype through surgical intervention. Additionally, root coverage was achieved across three teeth, as evidenced in the 4-week postoperative follow-up photograph. This dual outcome demonstrates the versatility of CTG procedures in addressing both phenotype modification and root coverage objectives simultaneously.
