Periodontal Surgery—Soft Tissue Graft
(Guided Tissue Regeneration)
Periodontal disease often refers to bacterial plaque and infections around the gum and tooth root. It can happen around one or several teeth. In some cases, the gum tissue is damaged or shrinks. In its more advanced stages, surgery to create new gum tissue (and even bone growth) can be done. There are several techniques used to encourage new gum growth using donor tissue, man-made material, or tissue from the roof of the patient’s mouth.
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Reasons for Procedure
This surgery is needed to:
Not all grafts are successful over time. The level of disease and your personal care routines will affect success.
If you are planning to have periodontal surgery, your dentist will review a list of possible complications, which may include:
Factors that may increase the risk of complications include:
What to Expect
Prior to Procedure
On the day of your surgery:
A local anesthetic will be used near the affected gum area.
Your dentist may recommend conscious sedation. You will be awake, but will have no anxiety during the surgery.
Description of Procedure
This surgery is usually done in an outpatient setting. You do not need to stay overnight. If you are undergoing sedation, the dentist or nurse will place an IV in your arm to deliver medicine. Your heart rate, blood pressure, and breathing will be monitored during and after the surgery.
The periodontist will numb the affected area with a local anesthetic delivered through a needle. The periodontist will make a small cut in the roof of your mouth and remove surface and/or connective (under the surface) tissue. This is the donor tissue that will be used for the graft. This area will then be stitched closed.
The new tissue flap will be repositioned on the damaged gum line and stitched into place. A dressing will be applied. A piece of mesh is sometimes placed between the gum and tooth to encourage growth.
If there is not enough donor tissue available on you, tissue from another person or man-made materials may be used.
How Long Will It Take?
The time it takes to complete the surgery depends on the level of damage and how much of the gum areas are affected.
How Much Will It Hurt?
You may feel mild discomfort while the periodontist numbs the affected areas for surgery, but you will not feel pain during the surgery. Medicines can help control pain and anxiety before, during, and after the surgery.
Healing will take place over the next 4-8 weeks. When you return home, do the following to help ensure a smooth recovery:
Call Your Dentist
After arriving home, contact your dentist if any of the following occurs:
In case of an emergency, call for medical help right away.
Academy of Periodontology
American Dental Association
National Institute of Dental and Craniofacial Research (NIH)
Canadian Dental Association
The Canadian Dental Hygienists Association
American Academy of Periodontology website. Available at: http://www.perio.org/ . Accessed April 19, 2010.
Carson De-Witt R. Periodontal disease. EBSCO Patient Education Reference Center website. Available at: http://www.ebscohost.com/thisTopic.php?marketID=16&topicID=1034 . Published September 1, 2009. Accessed April 21, 2010.
National Institute of Dental and Craniofacial Research (NIH). Periodontal (gum) disease. National Institute of Dental and Craniofacial Research (NIH) website. Available at: http://www.nidcr.n... . Accessed April 19, 2010.
Pre and postoperative instructions for periodontal surgery. Kathie L. Davis website. Available at: http://www.kldavie... . Accessed April 19, 2010.
University of Maryland Medical Center. Periodontal disease. University of Maryland Medical Center website. Available at: http://www.umm.edu... . Accessed April 19, 2010.
6/6/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/ : Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8.
Last reviewed September 2013 by Michael Woods, MD, Michael Woods MD