Gum tissue grafting is indicated for many clinical situations, including root coverage, increasing attached (keratinized) tissue or for ridge augmentation. Gum tissue can be taken from the palate or other areas of the mouth to reconstruct missing tissue around teeth. Dental products such as Alloderm, Emdogain, Mucograft and Gintuit are available to treat root coverage and increase keratinized tissue. In addition, new techniques using similar products have been aggressively marketed. How does a patient make an informed decision regarding these different treatment options?
Clinically speaking, the general consensus of research published in the dental literature shows that one’s own tissue provides the most root coverage, and the most keratinized tissue and maintains the thickness of grafted tissue, resisting future recession, over the longest period of time. In advertising and promotional material, companies compare the results of their engineered products to outcomes using the patient’s own tissue. In other words, the outcome with a patient’s own tissue is the gold standard and companies try to show that their results are “just as good as” those obtained with palatal tissue. Any technique in which collagen is utilized will ultimately show a decrease in tissue thickness since collagen is fully resorbed. It, therefore, has no advantage over using the patient’s tissue. Some newer techniques do not suture the surgical site, which can significantly increase the risk of post-surgical recession.
Another consideration in determining the ideal gum tissue grafting treatment option is the issue of comfort. Traditional surgical techniques harvest gum tissue from the palate and can often lead to complications and/or discomfort. In fact, the primary reason outside sources have been developed is to avoid a palatal surgical site.
In my practice, the preference, except when anatomically impossible, is to use a patient’s own tissue. The dental literature and my own experience treating thousands of sites confirm that the best results are achieved in this manner. My use of a microscope and microsurgical techniques can avoid any problems associated with palatal surgery. With increased magnification and the employment of tiny instruments used in eye and nerve surgery, microsurgical gum tissue grafting can be a minimally invasive experience with little to no discomfort for the patient.
If you would like to learn more about your gum tissue grafting options please call my office.
