Mucogingival Surgery

What is mucogingival surgery?

Mucogingival surgery or periodontal plastic surgery consists of a series of techniques that are applied to correct the quality of the soft tissues around implants and teeth.

Most mucogingival surgery techniques aim to create or gain gum, or to cover gingival recessions. Thus, the techniques will be:

Techniques to gain or create gingiva:

  • Free connective tissue grafting. A connective tissue graft is taken from the palate and placed in the recipient area. Normally it preserves all its epithelium and part of the connective tissue.
  • Free gingival graft. It is a keratinized connective tissue that is detached from its original site to be grafted in a different area. It is usually obtained from the palate and is used to reposition a deficit in quantity and/or quality of the gingiva that leaves the roots of the teeth (or part of them) exposed. Unlike epithelialized tissue, it receives blood supply both from the base and from the overlying flap.

Techniques to cover gum recessions:

  • Pedicled flaps
  • Free connective tissue graft

Mucogingival surgery seeks to create or gain gum, or to cover gingival recessions.

Why is it performed?

The use of mucogingival surgery has changed over time. First of all, it should be noted that the gums are an essential part of the mouth. They protect the jaws and prevent the entry of food or germs between the teeth, in addition to supporting the teeth, and the most common pathologies they usually suffer are periodontitis, so their health is very important. Over the years, different types of mucogingival surgery techniques have been performed, with the aim of:

  1. Gain keratinized tissue, which is done with grafts mentioned above.
  2. To cover gum retractions. The lack of gingival recession can lead to gingival inflammation, preventing good oral hygiene. In addition, gingival recession can affect esthetics.

When it comes to covering gingival recession, there is a classification established by Miller, according to the degree of coverage that can be achieved. The classification is based on three anatomical variables: a) the gingival margin; b) the mucogingival line and c) the integrity of the periodontal support at the mescal, interproximal and distal levels between the tooth and the recession.

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What does it consist of?

Mucogingival surgery consists of the correction of gum defects and all soft tissue that covers or surrounds the tooth. Thus, it treats the deficit of gum, whether in volume or height, around the tooth or implants. Enlarged or hypertrophic gums are also treated. Thus, by means of the techniques mentioned above, the aim is to:

  • To ensure closure after regeneration of increased bone volume.
  • To treat gingival defects, such as recessions, which cause root caries, sensitivity and unaesthetic appearance, as the root of the tooth is visible. This includes the different types of gingival grafts.
  • Improve the grayish coloration of some gums with implants.
  • Increase keratinized gingiva in back areas, improving hygiene.

Preparation for mucogingival surgery

Before the intervention, a correct diagnosis of the area to be treated should be made, analyzing the characteristics and conditions of the teeth and the patient. Thus, the specialist in Dentistry and Stomatology will be able to choose the most appropriate technique in each case to ensure the success of the treatment and that the patient feels as comfortable as possible.

Care after the intervention

After mucogingival surgery, the patient must take into account that the stability of the operated tissues plays an essential role in the success of the intervention. Thus, in the postoperative period the patient should follow a soft diet, control the operated area with mouthwashes and not use a toothbrush until the specialist indicates it. In addition, antibiotics should be taken to avoid any possible infection and anti-inflammatory drugs. Absolute rest is not necessary, but what is known as “active rest”, that is to say, avoiding any excessive movement that could cause problems in the area.

Alternatives to this treatment

There are no alternatives to mucogingival surgery. There are several techniques to achieve the desired effects and improve the functionality and esthetics of the patient’s gums.