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Soft tissue reconstruction

author icon By Dr. George Ghidrai

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 gum graft to cover
an area of exposed tooth root

The gum (or gingiva) surrounding a tooth has a 2-3 mm band of bright pink, very strong attached mucosa (marked with a, image bellow), then a darker, larger 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 :

  • A roll of tissue adjacent to an implant can be moved towards the area

  • Gingiva from the palate can be transplanted

  • When a larger piece of tissue is needed, a finger of tissue based on a blood vessel in the palate can be repositioned to the area

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 papilla black triangle papilla black triangle

Last review and update: February 2019



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