Gum grafting is a surgery that is often necessary to protect teeth from the damaging effects of gum recession and can also be used to improve the appearance of a smile. Gum recession is a common problem that affects many adults, but it often goes unnoticed until it is very severe. Gum grafting using traditional procedures includes removing palatal connective tissue from the patient to then using in the graft. In this case, patients can often expect to heal within a week or two, and requires the patient to limit their food intake to soft and cool foods.
AlloDerm, an acellular dermal matrix originally used to cover burn wounds, is now being used in periodontal plastic procedures to perform gum grafting for root coverage. This exogenous tissue is considered advantageous because it eliminates the need to obtain a palatal connective tissue graft from the patient, resulting in less patient downtime. On the surface, this new material provides a promising outlook on patient quality of life. It reduces pain following the procedure, significantly reduces the complexity of the grafting process, and reduces healing time.
Both AlloDerm and traditional procedures will show a similar amount of root coverage, bone regeneration, cementum, and biologic width formation. However, current research shows that, for gum grafting procedures, a connective tissue graft results in more keratinized tissue production and maintenance of the soft tissue thickness at the gingival margin as compared to AlloDerm. These types of results are not acceptable in many cases for my New York patients when there are better options.
Therefore, except when it is impossible to obtain a graft from the patient, I prefer to use a connective tissue graft rather than Alloderm. This does not, however, mean that I am neglecting new technologies. Microsurgery, as utilized in my New York practice, offers a clear advantage. With the increased magnification and illumination of the microscope, significantly smaller instruments, and microsurgical techniques utilized to obtain a palatal connective tissue graft, the patient experiences little to no pain. Thus, the benefits of Alloderm from a patient and clinical result perspective do not apply. Not every piece of new technology promises the same revolutionary results as others, and often new technologies overlap in their effects. I have seen that micro-surgical techniques can provide the same gains with little no to setbacks.
Patients can have the best of both worlds. Using the knowledge I have acquired in microsurgery, I can now regenerate the maximum amount of keratinized tissue, create a thicker tissue at the gingival margin and causing little to no discomfort while using the patient’s own tissue. I am constantly looking for, and critically examining, new technologies for my New York patients. Gum grafting patients need not sacrifice quality of treatment for quality of life.
Patients at my New York City practice can be assured that I have taken the time and effort to treat their individual case, and weighed every option to come to the best possible option. Call (212) 702-9088 or come in for a consultation at any time, and we will see what type of treatment we can provide to meet your needs.
*Clinical and Histological Evaluation of an Acellular Dermal Matrix Allograft in Combination with a Coronally Advanced Flap in the Treatment of Miller Class I Recession Defects: JClinPerio2009-Nunez, J
