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The Best Periodontal Procedure For Exposed Roots

Maintaining a high standard of oral hygiene is admirable. However, excessive and traumatic tooth brushing can lead to gum recession. Gum recession usually develops at the buccal site of teeth, causing exposed roots. At East Village Dental Center, soft tissue graft in New York is used to help patients eliminate gum recession and improve their gum line’s esthetics.

The causes of gingival recession are multifactorial. They include:

  •         Anatomical factors: Gingival recession is prevalent in patients with deficient soft tissue volume and lack of keratinized tissue at the teeth’ buccal side.
  •         Pathological factors like increased plaque formation causing inflammation, excessive and traumatic tooth brushing, bad habits like smoking, and having intra-or perioral piercings.
  •         Physiological factors: Patients with certain physiological defects like aesthetic impairment, dentin hypersensitivity are more prone to gingival recession.

Soft tissue grafts surgical procedure

Dentists commonly use soft tissue grafts to cover exposed roots. The grafts increase soft tissue volume and the width of keratinized tissue.

Pre-surgical treatment consists of thorough professional dental cleaning and oral hygiene, which help to eliminate etiologic habits. Before the surgery, your dentist will ask you to thoroughly rinse your mouth using a 0.2% chlorhexidine digluconate solution.

The surgery begins with your dentist injecting local anesthesia to help numb the donor and recipient sites. He will then make an intracellular incision on the buccal part of the affected tooth. Your dentist will then surgically create new papillae by horizontally extending the incision to the mesial and distal papilla basis.

Afterward, your dentist will make two additional oblique releasing incisions from the end of the horizontal incisions to beyond the mucogingival junction. He will then use a microsurgical blade and raspatorium to mobilize the formed trapezoidal flap.

Using the two-step modified trapdoor technique, your dentist will harvest the connective tissue graft with epithelial striation at the donor site from the palatal masticatory mucosa using mucotome blades of different widths.

  •         In the first step, your dentist elevates an epithelial flap using a mucotome blade with a width of 6 mm.
  •         The second step involves epithelial striation using a mucotome blade with a width of 8 mm to create a connective tissue graft.
  •         Your dentist will reposition and secure the epithelial flap with a continuous suture and modify the connective tissue graft with epithelial striation on a sterile glass plate. The modification is done using sterile physiologic saline solution and under constant humidification.

Glandular and fatty tissues are then removed and the epithelial striation partially de-epithelialized to minimize coronally advanced flap and epithelial striation overlap.

The mesial and distal anatomical papillae are also de-epithelialized with a scalpel. The connective tissue graft with epithelial striation is placed at the recipient site fixed using re-absorbable sutures.

Finally, your doctor will compress the treated area for about 1 min with a sterile gauze swab that has been soaked in sterile physiologic saline solution. This step promotes healing and minimizes hematoma formation.

Soft tissue graft post-surgical care

After the procedure, your doctor will instruct you to rinse your mouth for 1 min with an isotonic sodium chloride solution. Additional rinsing with 0.2% chlorhexidine digluconate solution twice a day is also recommended.

Your doctor will advise you to stick to soft foods and avoid excessively moving your mouth and mechanically cleaning your teeth through brushing or flossing for at least three weeks. Your dentist will remove the sutures 8-14 days post-surgery.

To learn more about soft tissue grafts or other periodontal procedures, contact East Village Dental Center today.