Indications for gum correction – recession coverage

Indications for gum correction – recession coverage

Appearance is not a medical indication, yet aesthetic considerations are among the most common reasons for treating a recession. Lost gum tissue can often be treated with surgery to regenerate the soft tissue. Before any such reconstruction, existing inflammation must be brought under control by appropriate preventive measures. When attached gum is rebuilt, a substitute material is placed where the tissue has been lost; during the healing process the body replaces it with its own soft tissue. The advantage over harvesting soft tissue from the palate: placing the material is gentler on the tissue and the operation is shorter. The second procedure to harvest the patient's own tissue is avoided, as are pain or infection at the donor site. Patients can return to their normal daily routine sooner.

The aim of gum correction is to cover the root surface as completely as possible. Depending on how much soft tissue between the teeth has been lost, or whether the papilla has gone, complete coverage may no longer be achievable.

Indications for gum correction – recession coverage: surgical recession coverage creates the biological conditions for the gum to regenerate and is recommended for the following aims and indications.

Aims and indications

Halting the recession of the gum

Covering exposed tooth necks where the appearance is impaired

Covering exposed tooth necks where function is impaired

Covering exposed tooth necks in sensitive teeth

Protecting tooth substance by covering the root, as caries prophylaxis

Making good the damage caused by a faulty brushing technique

Making plaque control easier

Changes to the gum in the course of orthodontic tooth movement

Insufficient width of attached gum

Eliminating periodontal pockets

Bone grafting / augmentation

Free mucosal graft

A mucosal graft – connective tissue with a layer of epithelium – can build up new volume to cover a recession. Under local anaesthetic, tissue is taken from a smooth area of the palate and laid on the exposed root surface. The graft is pushed under the gum and sutured. Healing to an aesthetically pleasing result can take several months. Where the treatment succeeds, a lasting widening of the attached gum can be expected.

Connective tissue graft

The aim of a free connective tissue graft is to add tissue in order to widen the gum. As with a free mucosal graft, the tissue is taken from the palate. In this case, however, only connective tissue is removed from a pouch, which is then sutured directly. The gum margin around the recession is released under local anaesthetic. The graft is pushed into the pouch that forms so that the exposed tooth neck is covered, and is then sutured in place.