Gum graft: types and possible complications

Gum graft is a surgical procedure performed to treat gingival recession. In this pathology, part of the roots of the teeth are exposed by the loss of soft tissue and even bone.

The gums have the function of sealing around the neck of each tooth to protect the bone and other supporting tissues. This defense mechanism against the outside is altered when, for various reasons, a retraction occurs.

This is when this intervention is necessary. It consists of remove soft tissue from another area of ​​the mouth to cover the root of the tooth that has been exposed. It is also used to veneer bare dental implants.

In this way, the protection offered by the gums is recovered and the aesthetics of the smile are improved. Are you interested in knowing more about it? This time we tell you how it is done, what are its complications and what care should be taken into account. Keep reading!

Why are the gums receding?

The gingiva supports the teeth and protects them from the mechanical aggressions of brushing and chewing, as well as from bacteria and their acids. Fill in the spaces between the teeth to prevent accumulation and packing of food debris.

Gum recession is a relatively common problem. Those who suffer from it not only see their aesthetics altered, but they can suffer from tooth sensitivity. In addition, the prognosis of your teeth or implants is also affected. It happens at any age and originates from various causes.

Periodontal disease

The beginning of the ailment happens with gingivitis, which is the inflammation of the gingival tissue. It swells, hurts, bleeds, and looks red. Without treatment, the evolution is periodontitis or pyorrhea, which involves the bone that surrounds and supports the teeth.

The accumulation of tartar or solidified bacterial plaque is associated with this condition. This hurts the gingival mucosa. Thus, at any stage of periodontal disease, receding gums can occur.

Incorrect tooth brushing technique

Excessive toothbrushing, with inappropriate movements or with great force, can cause the gums to migrate. The use of toothbrushes with very stiff bristles is also a risk factor.

• It is advisable to use toothbrushes with soft bristles. It is also convenient to clean with the modified Bass technique.
• The brush is placed inclined, at the junction of the gum with the tooth. The movements should be circular and sweeping, smooth and applying light pressure to the teeth.
• Very fast, horizontal movements and with excessive pressure should be avoided. These not only do not sanitize properly, but they hurt the gums.

Tooth movements

The use of orthodontics can cause gingival retraction. After the movements suffered by the teeth with the treatment, this gum problem occurs. It is important that during the use of the appliance the displacement factor is controlled.

Trauma also affects the gingival tissue. Suffering a blow to the mouth can displace the tooth outward, leading to the problem of retraction. Likewise, there is more predisposition in patients suffering from bruxism.

Repetitive movements and squeezing of the teeth causes the loss of enamel in your neck. These small lesions, which look like wedges or bites, cause the recession of the gum.

It may interest you: Types of orthodontics: which is the most appropriate?

Harmful habits

The habit of biting external elements, such as toothpicks, nails or pencils, can traumatize the gum until it retracts. The presence of piercings on the lips or tongue is also a causal factor. The use of tobacco is another habit that undoubtedly affects.

Patient's own susceptibility

There are certain biotypes of thinner gums and with a greater predisposition to suffer recession. Thicker gums, on the other hand, retract less frequently. Hormonal changes (pregnancy) or the age of the person also influence the appearance of this problem.

What types of gum graft are there?

The gum graft consists of the extraction of a portion of donor tissue to place it on an exposed tooth or implant area. There are multiple techniques and different tissue donor sectors. Next, we explain the most common ones.

• Coronal replacement flap or pedunculated gingival graft: here part of the gingiva near the area to be treated is lifted, to stretch it and cover the exposed root. There is no donor area, but the gingiva itself is used and relocated in the correct place.
• Free gingiva graft: A portion of palatal mucosa tissue is taken at the molars and remolars, in the outermost layer of the palatal gingiva, that is, the one closest to the teeth. This graft is placed in the area to be covered. It has the particularity of generating the formation of free gingiva, very similar to the normal one.

• Tunnel graft or on: in this case, the graft is extracted from the palate or the tuberosity (sector behind the upper wisdom teeth). A bed is made in the middle of the pieces that are going to be covered to receive the graft. It is useful in cases where you want to gain gum thickness or thickness.

As we already mentioned, the donor areas to perform the flaps come from the following sectors:

• Hard palate: the area extends from the third molars to the canine. The size of the flap depends on the area to be covered. It offers good mucosa thickness and can be used for both tunnel grafting and free gingiva techniques.
• Tuberosity: It is the area that is located behind the third molars. Provides a flap of good tissue thickness.

Possible complications during gum grafting

Like any surgical act, the gum graft can have some complications. However, they are not usually frequent. In any case, It is advisable to consult your doctor or dentist in case you experience them.

Postoperative bleeding

In some cases, the bleeding is considered normal. It happens when, at the end of the anesthesia, the donor or recipient area bleeds. By placing a gauze and applying pressure it is usually contained. Even so, it may happen that the bleeding does not reverse with the placement of the gauze.

In those cases, the treating professional must resort to the placement of hemostatic agents to control bleeding. Sometimes stitches may also be necessary. The important thing is to control the bleeding before the person leaves the clinic.

Graft necrosis or mobility

This complication refers to the death of the placed tissue, or its displacement. There are several reasons why it can occur. One of them is an incorrect performance of the suture technique by the surgeon, which means that the flap is not immobilized.

On the other hand, It can happen because the patient makes some movement in the area that releases the stitches. Despite this, a portion of necrosis and a partial contraction at the wound edges are quite frequent and expected.

Lack of coverage of the area

If the treated area is not completely covered, it is necessary to proceed surgically again. The placement of a second graft will be necessary to complete the discovered area.

Those who are going to receive a gum graft should be warned of this complication in advance, since the expected results are not always achieved on the first attempt.

Pain

Post-surgical pain is a possibility. In any case, it is usually bearable and without excessive discomfort if the recommendations given by the surgeon are followed.

In general, a transparent mesh is usually placed over the donor area to protect it from the outside and reduce discomfort. The intervened patients report the sensation of having their mouths "like being burned with food."

The surgeon indicates the use of analgesics and anti-inflammatories to reduce discomfort and promote recovery. Antibiotics are not usually necessary.

Advice and care for the gum graft postoperative

Once the surgery is finished, the professional usually suggests some care to promote recovery. These, in turn, they avoid discomfort or complications. The most common include the following:

• Eat cold and soft foods. Avoid hot and hard foods, as they promote bleeding and trauma.
• Apply ice or cold compresses in the area to reduce inflammation.
• Do not perform mouthwashes.
• Do not brush the area. Sanitize the rest of the mouth very carefully so as not to hurt the wound or remove the stitches.
• In case of bleeding, place a dry gauze and compress the area.
• Do not make sudden movements of the mouth such as playing musical instruments, blowing up balloons, or playing contact sports. Also do not stretch the lip and cheeks to look, because the points can come out.

• Avoid the use of tobacco, as it makes healing difficult.
• Take the prescribed medication by the professional.

Read also: 8 cares for after tooth extraction

The gum graft to restore the smile

Gingival recession is an aesthetic problem for those who suffer from it, as the smile is altered and the teeth appear longer than normal. In addition, the teeth do not have the protection of the gum, which increases the risk of mobility and sensitivity problems.

The gum graft is the most effective and accessible solution to solve this problem. It is a simple surgery that allows covering the exposed roots and improving the thickness of the gingival tissue. With this simple treatment, it is possible to regain the protection of the teeth and the appearance of the smile.