Gum Grafting (Subepithelial connective tissue grafts) |
surgical procedures |
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When recession of the gingiva 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 often remains and protects the tooth, so that no treatment other than modifying home care practices is necessary. However, when recession reaches the mucosa, the first line of defense against bacterial penetration is lost.
In addition, gum recession often results in root sensitivity to hot and cold foods as well as an unsightly appearance to the gum and tooth. Also, gum recession, when significant, can predispose to worsening recession and expose the root surface, which is softer than enamel, leading to root caries and root gouging.
Examples of Connective Tissue Grafting
In situations where there is gum recession that is noticeable when you smile, a connective tissue graft can cover the root surface and recreate your natural smile. The result is a well blended gumline that has the same color and shape as you had originally.
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| Before Connective Tissue Graft | After Connective Tissue Graft |
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| Before Connective Tissue Graft | After Connective Tissue Graft |
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| Before Connective Tissue Graft | After Connective Tissue Graft |
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| Before Connective Tissue Graft | After Connective Tissue Graft |
A gingival graft is designed to solve these problems. A thin piece of tissue is taken from the roof of the mouth, or gently moved over from adjacent areas, to provide a stable band of attached gingiva around the tooth. The gingival graft may be placed in such a way as to cover the exposed portion of the root.
The gingival graft procedure is highly predictable and results in a stable healthy band of attached tissue around the tooth.
Root Coverage with AlloDerm®
What is Root Coverage?
"Root coverage" is the procedure to cover a tooth root that has become exposed. This exposure is known as a recession defect.
Why do I need to treat it?
The decision to treat exposed tooth roots can be based on either a dental necessity or personal choice. Treatment can eliminate potential plaque traps and prevent the formation of root caries. Exposed roots can also lead to root sensitivity, especially to hot and cold temperatures.
What are my options?
In the past, the most common treatment was to harvest tissue from the roof of the patient's mouth. This option creates another surgical site and may require multiple visits and surgeries to complete the treatment. Another option is to use AlloDerm® rather than harvesting from the roof of the mouth.
Why do I want AlloDerm®?
AlloDerm® is a source of the tissue necessary for root coverage treatment. Since it is an "off-the-shelf" product, many teeth can be treated in one visit.
AlloDerm®
What is an AlloDerm® dermal graft?
AlloDerm is donated allograft skin which is processed by LifeCell corporation to remove cells, leaving only the dermis, or bottom layer of the skin.
How is donated skin obtained?
Tissue banks regulated by the U.S. Food and Drug Administration (FDA) and the American Association of Tissue Banks (AATB) throughout the United States surgically remove a thin layer of skin from donors using sterile operating room techniques. The skin is placed in to an antibiotic solution and shipped to LifeCell. Donors and their families receive no financial compensation for these donations, and donated tissues are not bought or sold. However, fees are paid to cover the standard cots for obtaining, testing, processing, and shipping the tissues.
How long has AlloDerm® been used?
Use of AlloDerm® began in 1992 for burn patients and in 1994 for periodontal surgery and plastic and reconstructive surgery. Currently, more than 25,000 patients have received AlloDerm® gifts.
How is AlloDerm® made?
LifeCell Corporation processes the human donor skin in order to remove cells. This process involves removing the epidermis (the top layer of skin cells) and all of the cells in the dermis. The remaining material is a collagen framework which provides strength to the skin. There are no components left to cause the rejection or inflammation that can result with unprocessed tissue transplants. Therefore, when transplanted to a patient, the AlloDerm® graft gradually becomes a natural part of the patient's own tissue and performs like normal, healthy tissue thereafter.
Safety
Are AlloDerm® grafts safe?
Before LifeCell receives the skin, the tissue donors undergo rigorous screening by the Tissue Bank. The donor's medical and social history and cause of death are carefully reviewed and documented. Blood samples are extensively tested by the Tissue Banks or a certified laboratory using FDA- licensed tests. The donor must be found negative for Hepatitis-B and C, HIV Types 1 and 2 antibodies (screening for AIDS), and syphilis. As an extra safeguard, AlloDerm® grafts undergo microscopic and other analytical testing, both before and after processing, to rule out pathogenic contamination and to promote uniform quality.
What about HIV transmission?
Human pathogenic viruses, including HIV, require certain types of human cells to be present and alive in order for the viruses to live an grow themselves. These viruses essentially are "parasites" of cells and cannot reproduce without them. The AlloDerm® removes all cells, thereby removing the components necessary for survival and transmission of these viruses. Additionally, after cell removal, the AlloDerm® grafts are freeze-dried. There has never been a documented case of HIV transmission from the transplant of any freeze-dried, processed tissue graft.
Is it regulated by any agency?
AlloDerm® is regulated by the FDA as human tissue, and is indicated for transplantation to repair or replace damaged or inadequate gingival tissue.
The Healing Process
What should I expect after my surgery?
You most likely will have some sutures closing the surgical incisions, and you may have a dressing after the surgery that needs to stay securely in place until it is removed by your surgeon. For the first 1 or 2 weeks of healing time, you must treat the graft very carefully and take great care not to disturb it.
For the first 10-14 days following surgery, you should avoid eating granular foods such as nuts or corn. Additionally, you should avoid using toothpaste. You may brush areas away from the surgical site with tap water. A mild mouth rinse containing chlorahexidine may also be used.
Your doctor will give you more detailed information on how to take care of your surgical area and may also prescribe antibiotics foe you. After healing is completed, you will no longer feel the AlloDerm® graft, but it will still be present. Gradually, it will be replaced by your own gum tissue.
