Receding Gums: Donor Tissue vs. Patient Tissue

added on: July 26, 2013

The Topic of Receding Gums

As a practicing Periodontist in the OKC area, I see a majority of my patients have receding gums.  The severity of receding gums is variable and not all patients need treatment.  I base surgical treatment on severity and progression rate, type of defect, esthetic concerns, and if the patient is symptomatic.  Symptoms include sensitivity to hot and cold, painful to brush, and acute infections with swelling.  Common causes of receding gums include toothbrush trauma, thin biotype, previous orthodontic treatment, tooth mal-position, frenula-muscle pull, and inflammation.  I perform several surgical techniques to correct receding gums and increase the amount of attached tissue (keratinized gingiva).  Keratinized gingiva is the appropriate type of tissue that surrounds our teeth and is resistant to future recession.  A majority of surgical procedure utilize either a donor tissue or the patients tissue.  This is a common debate in periodontics.  Are the results equal in terms of root coverage, and what type of tissue is gained?  The dilemma with donor tissue is that root coverage is predictable, but the amount of keratinized gingiva cannot be determined.  The problem with harvesting the patient’s tissue is that a second surgical site is required and increased post op pain and bleeding.   I base my decision on what surgical technique to utilize on location and number of teeth involved and what is in the best interest long term for my patients.  I always inform my patients about the options and the good and bad with both techniques.  This allows my patients to voice there input and preference which contributes to my decision process.

Example of OKC patient with receding gums

I was recently presented with a interesting case that exemplifies this dilemma.  A OKC patient was referred from his general dentist with receding gums present on his lower teeth.  This is typically a area were I utilize the patient’s tissue due to the lack of keratinized tissue and muscle pull.  The patient had a similar procedure performed by another periodontist about 10 years earlier in a different location.  The patient expressed that he did not want to go through that procedure again.  After informing the patient about the possible consequences of using a donor tissue, we decided that this would be the best option for him.  I performed the procedure, and the patient experienced no complications and minimal amount of discomfort during healing.  The pictures below represent how the patient presented initially and 6 weeks after the surgical procedure.

 

 

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