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Soft tissue reconstruction


Last Updated: 10.01.2024

Author: George Ghidrai, MD  

Soft tissue reconstruction (also called gum graft or gingival graft) is a generic name for any of a number of surgical procedures whose combined aim is to cover an area of exposed tooth root surface or dental implant with grafted oral tissue.

gum graft

an example of a gum graft to cover an area of exposed tooth root


The normal gingiva

The healthy gum (or gingiva) surrounding a tooth has a 2-3 mm band of bright pink, very strong attached mucosa (marked with a, image below), then a darker, more extensive area of unattached mucosa that folds into the cheeks (marked with b, image bellow).

healthy gums

When replacing a tooth with an implant, a band of strong, attached gingiva is needed to keep the implant healthy in the long term. This is especially important with implants because the blood supply is more precarious in the soft tissues surrounding an implant.


Surgical procedure

When an adequate band of attached tissue is absent, it can be recreated with a soft tissue graft. Various methods can be used to transplant soft tissue:

Example

Gingival grafting to increase the zone of attached gum tissue around a dental implant:

gum graft for dental implant before

before

gum graft for dental implant after

after

Additionally, for an implant to look aesthetic, a band of full, plump gingiva is needed to fill in the space on either side of the implant.

The most common soft tissue complication is called a black-triangle, where the papilla (the small triangular piece of tissue between two teeth) shrinks back and leaves a triangular void between the implant crown and the adjacent teeth.

papilla black triangle


Generally, after the adjunctive surgical procedures are completed, a healing time is required before the implant placement can actually begin. The amount of healing time may vary depending on the type of procedures that were performed.





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