The “concept” of mucogingival surgery is a general term that encompasses a series of periodontal treatments aimed at correcting defects in the morphology, position and amount of soft tissue around both a tooth and an implant.
It consists of preserving both the health and esthetics of the gum by means of gum grafts (either from the palate, tuberosity or even from the area itself [pedicled]) in cases in which recessions are present.
There are situations in which mucogingival surgeries oriented towards implants are also performed, but in these cases the surgery is performed as a consequence of a deficit of soft tissue around the implant, so that the sealing of the implant to the bacteria found in the mouth is not guaranteed and could lead to bone loss in the implant in the future.
In what cases is mucogingival surgery used?
Mainly, this type of surgery is performed when the patient presents problems in the morphology, position and quantity of the gum. These problems develop when gingival recession occurs and leads to sensitivity. The main causes of these retractions are:
- Bruxism
- Aggressive brushing
- Piercing
- Orthodontics
- Trauma
- Tooth positions
- Removable prosthesis
- Bacterial plaque
When gingival recession occurs for any of these reasons, the ideal is to perform mucogingival surgery to prevent the recession from progressing.
In the case of implants, as already mentioned, this type of procedure is used when mucosa appears around the implant instead of gingiva, or this surgery can also be used when the patient has a deficit in the amount of gingiva.
These types of problems occur:
- After a great bone regeneration
- In areas where the extraction was performed a long time ago.
- In patients with misaligned removable prostheses that have been in the mouth for a long time.
- In patients with large bone defects.
Types of mucogingival surgery
- Pedicled soft tissue grafting procedures. They are performed when you can get the graft from the surgical site itself (without having to take it elsewhere). It can be of two types: Rotated or coronal advancement.
- Procedures in which we use membranes as a substitute for the gingiva itself.
- Free gingival graft procedures (palate or tuberosity). Within this procedure we differentiate between epithelialized graft and connective graft.
Finally, it should be noted that there are currently no alternatives to mucogingival surgery, although it is possible to make up by means of veneers and composites in certain very specific cases.