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Gum grafting surgery may be needed for a variety of reasons. A graft might need to be placed for repair and regeneration as in the case of periodontal disease or it might be needed for aesthetic purposes. Grafts may consist hard tissue or soft tissue.

Hard tissue grafts

These are used extremely frequently as a part of reconstructive and regenerative periodontal surgery. There are four common types of grafts that are used:

  1. Autograft
  2. Xenograft
  3. Allograft
  4. Alloplast

It is only in the first case that a second surgery site has to be created in the oral cavity, to harvest bone. This is the most effective kind of hard tissue graft, something that was proven beyond a doubt by a number of studies done all over the world.

The drawback is of course a longer healing time as well as the increased expense due to a second site of surgery.

Commonly nowadays the other types of grafts are being used in periodontal surgery. These are readily available commercially and save the patient a lot of discomfort and expense. The results vary much more with the use of these grafts with most experts agreeing that Allplasts basically act as inert fillers instead of actually causing or helping bone to form.

Soft Tissue Grafts

Similar to hard tissue grafts, soft tissue grafts may be harvested from the palate (most commonly) or they may be made in a laboratory.

These grafts are most frequently used for aesthetic purposes. Unlike hard tissue grafts, these grafts are most often taken from a donor site within the patient.

The different types of grafts used are:

  1. Free Gingival Grafts
  2. Connective Tissue Grafts

Free gum grafts are harvested from a portion of free gum in effort to increase the width of the attached gum, cover recession or to provide complete closure after a hard tissue graft surgery.

Connective tissue grafts are also used to cover areas of recession, to increase the width of attached gum, treat furcation defects and help close unsightly interdental "black triangles".

Harvesting a free gum graft is simpler than harvesting a connective tissue graft from the palate.

Healing After Graft Placement

Healing following the placement of the graft depends on a number of factors including the site of surgery, extent of surgery, patient hygiene and other habits like smoking and environmental factors.

As a rule of thumb however, placement of a bone graft (Except an autograft) along with periodontal surgery makes almost no difference to the healing time of the patient as there is no extra site of surgery for the patient. Antibiotic coverage is sufficient to allow healing to take place.

In the case of a soft tissue graft, however, a healing time of one to two weeks can be expected. Some amount of discomfort and pain will be present which can be managed with medication.

Care must be taken to maintain excellent oral hygiene as chances of graft failure are quite high with a soft tissue graft. A graft failure will manifest as a discolored and distinct mass of tissue that degenerates over time.

Complete healing and restoration of normal aesthetics takes 3-4 weeks.

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