Gingival grafting

Gingival grafting, also called gum grafting or periodontal plastic surgery, is a generic term for the performance of any of a number of periodontal surgical procedures in which the gum tissue is grafted. The aim may be to cover exposed root surfaces or merely to augment the band of keratinized tissue. The soft tissue in the oral cavity is classified as either keratinized or nonkeratinized based on the presence of keratin in the epithelium. In health, the soft tissue immediately around the teeth is keratinized and is referred to as keratinized tissue or gingiva. Alveolar mucosa is non keratinized oral epithelium and is located apical to the keratinized tissue, delineated by the mucogingival junction (MGJ). It should also be pointed out that mucosa can surround a tooth in health. Nonkeratinized tissue also lines the cheeks (buccal mucosa), underside of the tongue and floor of the mouth. The lips contain both non-keratinized tissue (on the inside) and keratinized tissue on the outside, demarcated by the vermillion border. The dorsum of the tongue is keratinized and features many papillae, some of which contain taste buds. Exposure of the tooth root due to loss of keratinized tissue around the neck of a tooth is referred to as gingival recession. This can result in sensitivity or pain from the exposed tooth root surface (dentin is more permeable and soft compared to enamel and dentin is what makes up the tooth root). Recession may also cause an unasthetic appearance especially if located in the anterior dentition (front teeth). While not all cases of gingival recession require surgical correction, there are various options if that is what the patient desires. It should be reinforced that recession left untreated will not result in tooth loss, contrary to popular belief. Also, recession that is left untreated can be maintained and the inflammation kept at bay with proper brushing and oral hygiene technique.