Healthy gum tissues create great smiles and help maintain your teeth.  However, when your gum tissue margin pulls away from your tooth exposing the tooth’s root, recession begins.   Receding gums is a start of a potentially serious oral health problem.  Fortunately, Dr. Fotek can reverse this gum loss by performing a predictable procedure. 


Gum recession is a wide spread problem that most people are unaware of.  If you are over the age of 40, there is a very high chance you may have gum recession.  When the gums are thin and weak due to a lack of tough and resilient attached gums, recession can quickly occur.  As recession progresses, both gum and bone are lost and the root becomes exposed.  This process is usually continuous and may lead to tooth loss.   Recession will also lead to tooth sensitivity, increased incidence of tooth decay or damage to the nerve.  Very often, dentists want to cover the recession area with a bonding material instead of alerting the patient to the problem and treating the cause of the recession; Masking the exposed tooth surface may only lead to further recession. 


Recession associated risk factors in those with thin tissues include:


1. Abrasion due to aggressive tooth brushing
2. Biting stress and overload from grinding or clenching
3. Increased functional load, i.e. supporting teeth for bridges or partial dentures
4. Braces and orthodontic therapy
5. Root exposure with high smile line (esthetic concerns)
6. Poor fitting restorations
7. Lack of keratinized or attached gingival tissue
8. High frenum – frenal pull
9. CPAP appliances and other non-dental appliances
10. Tongue or lip piercing
11. Trauma


Progressive gum recession can only be stopped by treating the underlying cause of the problem.  The damage caused by recession will not revert itself and will require corrective treatment to prevent future gum loss.  Depending on the location and cause of the recession, correction may be done utilizing one of various gum graft techniques with or without tissue repositioning. 


Don’t hesitate and come in to discuss your options for corrective root coverage treatment. 


Free Gingival Graft


The Free Gingival Graft is a technique frequently used to increase the amount of keratinized (tough and resilient) tissue surrounding a tooth or a dental implant. Keratinized tissue plays a pivotal role at maintaining gingival health around teeth and dental implants, while facilitating good oral care.  This graft technique is widely utilized when the tissue quality next to a tooth needs to be changed from a frail and thin tissue prone to further recession to one that is thick and tough, resilient to further recession.  Full root coverage may not always be achieved using the free gingival graft but altering the tissue morphology (type) next to a recession affected tooth will stabilize and “recession proof” the tooth.  


The tissue needed for the graft is usually obtained from the palate (roof of mouth) and is placed over the recession area.  Multiple teeth can be treated at a time in this manner.  The graft is secured in place and covered with a surgical dressing.  Both the donor and recipient site heal simultaneously.  The free gingival graft allows Dr. Fotek to save teeth that may have otherwise been lost due to progressive gingival recession.


Connective Tissue Graft


Connective Tissue Graft is the gold standard for correction of recession (gum loss).  It is one of the most predictable approaches for correcting recession defects, mainly because it uses your tissue to cover your recession.  Clinical studies show that connective tissue grafts covered an average of 86% of the initial gum recession while complete root coverage is attainable in nearly 61% of the teeth that are treated.  In incipient lesions, full root coverage can be easily achieved.  No other root coverage procedure is as predictable and as esthetic as the connective tissue graft, that is why it is currently the preferred approach.  


The connective tissue graft involves placement of a graft directly over an exposed root.  After a thorough numbing, a tiny cut is made in the gum to create a gum pouch over the tooth with recession.  After the graft is obtained from a secondary small cut on the palate, it is placed over the recession area and covered by the gum pouch.  In this manner, your gum tissue that will provide a good supply of nutrients to the connective tissue graft while maintaining its viability.  Both the donor tissue site and recipient site will heal over the next few days.  The donor area will fully regenerate itself by recreating new tissue that can be used again within a few months.  The recipient site will heal virtually without any scarring.


The effect of the connective tissue graft is an aesthetic correction of recession and stabilization of the tissue to minimize future recession in the same area.  It creates a thicker and stronger gum tissue.


AlloDerm® 


AlloDerm® provides a predictable alternative to treating gum recession.  It is intended for the correction of gingival recession in lieu of a gum graft, when there is not enough available gum tissue or its procurement is undesired.  AlloDerm® is an Acellular Dermal Matrix (ADM) from donated human skin tissue acquired by tissue banks utilizing strict standards of the American Association of Tissue Banks and FDA guidelines.  It is a dermal (skin) matrix that allows Dr. Fotek to give you the necessary tissue graft, without the limitations associated with harvesting the graft material from the roof of your mouth.  Not only does it lead to fast healing, with AlloDerm® there is no need for a second surgical (donor) site, which means less pain and faster recovery.  


Aside from its gum recession corrective application, AlloDerm® has been extensively utilized in the treatment of burn reconstruction and plastic reconstructive surgery.  It is a very safe and effective regenerative material.  


In its over a decade of use, there has never been a reported case of any viral disease transmission from AlloDerm® tissue.  This is largely due to the strict guidelines followed from the time the skin donor is selected through its numerous washes and freeze drying steps.  All tissue donors are screened and tested to reject those who may have been exposed to HIV, Hepatitis B & C and other viral and microbial pathogens.  This is the first safety measure.  The tissue is then processed to remove all living (cellular) components.  After this inactivation step, the recipient (you) can no longer reject this graft tissue.  What is left is 3D scaffolding largely composed of collagen fibers to support tissue growth and elastin filaments for biomechanical strength.  


If you were always apprehensive to treating your gum recession due to potential post-operative pain, AlloDerm® may be the answer.  Come in and discuss your treatment of gum recession options with Dr. Fotek.



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