Gum Grafting Procedures (Sub-Epithelial Connective Tissue Grafts)

When recession of the gingiva (gums) occurs, the body loses a natural defense against both bacterial penetration and trauma. When gum recession is a problem, gum reconstruction using grafting techniques is an option.

When there is only minor recession, some healthy gingiva (firm or attached gum tissue) often remains and protects the tooth, so that no treatment other than modifying home care practices is necessary. However, when recession reaches the mucosa (loose or unattached gum tissue), the first line of defense against bacterial penetration is lost.

Treating Gum Recession

In addition, gum recession often results in root sensitivity to hot and cold foods as well as an unsightly appearance of the gum and tooth. Advanced gum recession can predispose to additional exposure of the root surface and result in further structural compromises such as root caries and root gouging. As additional gum recession occurs, the underlying bone will recede and weaken the tooth support further.

A gingival graft is designed to solve these problems. A thin piece of tissue is either taken from the roof of the mouth or from an adjacent area to provide a stable band of attached gingiva around the tooth. The gingival graft may be placed in such a way as to cover a portion, or all of the exposed root surface. The gingival graft procedure is highly predictable and results in a stable healthy band of attached tissue around the tooth.

AlloDerm (alternative donor tissue for soft tissue grafting)

We also offer the use of an alternative grafting technique, which employs the use of a human skin tissue product called Alloderm. The use of this material eliminates the need for a second surgical site (donor site) and is very safe and effective. In fact, it is widely used in the medical field for burn victims and plastic surgery purposes.

Soft Tissue Grafting with AlloDerm Regenerative Tissue matrix results in Root Coverage results comparable to autologous tissue or your own tissue. AlloDerm consists of a collagen matrix that preserves all the elements necessary for revascularization and cellular repopulation. Multiple prospective human clinical investigations have documented equivalent root coverage results to connective tissue grafts. Multiple investigations have also documented esthetic results equivalent to autologous connective tissue. AlloDerm serves as a scaffold for epithelial cell migration, thus allowing pigmentation and contour to emulate surrounding tissues.

The use of AlloDerm, allows for the option for multiple sites to be treated in a single surgery. This benefit can help to decrease the number of treatment appointments and eliminates the dependence of how much palatal tissue is available for a soft tissue grafting procedure. AlloDerm also gives an option for treating patients that have inadequate harvestable tissue (due to age or compromised health) or simply prefer not to have surgery on the palate for donor tissue removal.

Other Procedures that can benefit from AlloDerm:

AlloDerm can be used in a variety of oral grafting procedures such as soft tissue ridge augmentation. It is especially useful in mandibular overdenture cases where a free gingival graft procedure is needed to widen the area of attached gingiva and increase the depth of the vestibule.

AlloDerm Regenerative Tissue Matrix

AlloDerm is widely used in both medicine and dentistry for plastic and reconstructive surgery. Originally developed to treat burn patients, it is now used in general surgery, orthopedic surgery and urogenital surgery in addition to its applications in dental surgical procedures. Since its introduction in 1994, there have been more than 900,000 AlloDerm grafts placed with no incidence of disease transmission.

AlloDerm is a processed tissue that comes from donors who are extensively screened and tested for presence of diseases including HIV and hepatitis. The processing procedure has been demonstrated to reduce HIV and hepatitis C surrogate virus to non-detectable levels. Additional testing for presence of pathogens is performed prior to and following processing to ensure that AlloDerm is disease-free before release for patient care.

AlloDerm Processing

A buffered salt solution removes the epidermis, and multiple cell types within the dermis are then solubilized and washed away using a patented series of non-denaturing detergent washes that rapidly diffuse into the dermis. The processed regenerative human tissue matrix is then preserved using a patented freeze-drying process, which prevents damaging crystal formations, thereby retaining the critical biochemical and structural components needed to maintain the tissue’s natural regenerative properties.

PUROS DERMIS (Allograft Tissue Matrix)

Puros Dermis is a natural alternative to autogenous (your own) soft tissue grafts. It can be used in for various applications for soft tissue augmentation: to increase volume and provide a highly cosmetic clinical result. Puros Dermis exhibits superb soft tissue response and maturation, ideal for aesthetic case requirements.

Benefits include:

  • It is a natural biological matrix designed for successful soft tissue enhancement, around teeth and implants.
  • It reduces morbidity and eliminates the need for a second surgical site that is usually required for harvesting donor gum tissue.
  • It retains the natural collagen matrix and mechanical properties of native dermis due to the proprietary Tutoplast Process. It exhibits multidirectional strength and exceptional adaptability to surface contours.
  • Long history of effective clinical results in a variety of surgical applications.

The Puros Allograft family of products is refined using the proprietary, 5-stage Tutoplast sterilization process. While preserving the valuable collagen matrix and tissue integrity, this process gently removes unwanted materials such as cells, antigens and viruses, as well as inactivating pathogens. Tutoplast-Processed tissues have been used for over 30 years in more than one million procedures without a single reported case of disease transmission.

  • Osmotic treatment Kills bacteria, destroys and removes unwanted cells, further reduces viral load
  • Oxidative treatment Destroys remaining proteins and minimized potential graft rejection
  • Alkaline treatment Further reduces prion infectivity
  • Solvent dehydration Removes water from tissue and acts as a disinfectant, further reducing prions
  • Limited-dose gamma irradiation Provides a sterility level of 10-6 and preserves graft integrity