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What is a Gingival Graft?

By Misty Wiser
Updated May 17, 2024
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A gingival graft is a piece of tissue used to surgically replace missing gum tissue. These grafts are used in periodontal surgery to sculpt and augment thin gum tissue around the roots of teeth exposed due to gum recession. During a gingival graft surgery, a strip of gum tissue is usually harvested from within the patient’s own mouth. Four types of gingival grafts are used to reverse gum recession, preserve the jawbone, and create a cosmetically appealing gum line.

The lateral pedicle graft is used when there is plenty of healthy gum tissue next to the damaged area. Three sides of neighboring flaps of gingival tissue are snipped free and carefully positioned over the area of missing gum tissue. It is then sutured into place until the graft is healed. These sutures are removed in a follow-up office appointment within two weeks of the surgery. The gum excision site is left open and may be very painful during the seven to ten day healing period.

Another gingival graft is called a subepithelial connective tissue graft. Healthy donor gum tissue is harvested from underneath the surface of the palate in the mouth. A small incision is made before the periodontist excises a thin slice of gum tissue, then the donor site is closed with dissolvable sutures. Enough tissue can be collected during one graft surgery to repair the damaged gums of several teeth. This procedure is less painful than the other graft operations because the donor site is not exposed during the healing process.

A third type of graft is called a free gingival graft. The top layer of tissue is excised from the surface of the palate, and the donor excision site is left open until it heals. Only a small amount of usable gum tissue can be harvested during this operation. A free gingival graft is used for gum repair around a single tooth.

If a person does not have enough acceptable gingival tissue for harvesting, a gingival graft made of donated human skin may be used. The acellular dermal matrix graft is not always successfully implanted into oral tissue. Most periodontal surgeons prefer to use gingival tissue taken directly from the patient because the graft is less likely to fail.

Healing from gingival graft surgery may take as long as three weeks. Ice packs, soft foods, and pain medication are usually needed for the first few days. The palate of the mouth may need to be covered with a soft material to prevent irritation of the healing tissue. After the gingival graft surgery heals, most people report a reduction in painful tooth sensitivity to hot and cold temperatures.

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