Soft Tissue Grafting

Gingival recession is an exceptionally common malady, and the most common reason patients are referred to periodontists for treatment.  Gingival recession, or mucogingival defects may be caused by periodontal disease.  As bone is lost due to disease, the soft tissue level follows as well.  Other causes of gingival recession are trauma, such as toothbrush abrasion, and malocclusion (bad bite).  Malocclusion will be discussed in greater detail later.

Soft tissue grafting can be accomplished either with the patient’s own tissue, or with donor material.  Generally donor material is used to treat more extensive generalized lesions, and serves to thicken and strengthen soft tissue rather than to fully cover the roots of the teeth.  There are many advantages to using the patient’s own tissue.  It is unlikely to elicit an immune response, and therefore is less prone to rejection.  It contains live cells, which assist in healing, and it is generally the same color, so as grafts heal, they blend in more thoroughly.

Soft tissue harvested from the palate has many advantages, its chief disadvantage is a lack of abundance.  A very small area in the palate can be sourced for donor material.  This area is bound by specialized tissue on the front and back, a large blood vessel toward the center, and the teeth on the fourth side.  Generally enough tissue to treat one to three teeth is able to be harvested from the palate.

When soft tissue grafts are harvested from the palate, I generally harvest tissue only from one side, so the second side is able to function without impediment.  Soft tissue grafts are harvested in a very gentle and conservative manner.  A “trap door” of overlying tissue is dissected, left attached, and tissue is removed from beneath.  The “trap door” is then closed, and the wound edges secured with sutures.  A clear acrylic stent is fabricated and worn by the patient for five days following surgery. This stent significantly reduces post-operative discomfort, bleeding, and molds the tissue to its original shape, facilitating healing without a soft tissue defect.

Soft tissue grafts and the palatal donor site resolve rapidly, however like all healing tissue there are phases of healing, potential complications.  Bleeding from the palate is rare, but is of primary concern.  Wearing the clear palatal stent will markedly or completely eliminate the potential for bleeding from the tissue donor site and allow the tissue to regenerate to its original contour.  As the tissue heals, it will initially be discolored, and may have a whitish sheen, or may be dark red or purple and slightly inflamed.  This is natural, and it will become pink and firm in a short time.  The grafted tissue is quite delicate, and pulling down one’s lip to look at the graft, or eating without caution can damage the graft, so both are best avoided.

Four Convenient Locations for Periodontal Therapy, Dental Implant Surgery and Third Molar Extraction

South River Periodontics
Annapolis Location

104 Forbes St, Suite 204,
Annapolis, MD 21401
(410) 295-1000

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Barrington Location

310 Maple Ave, Suite 107,
Barrington, RI 02806
(401) 247-2200

Barrington Rhode Island (Maple Avenue Family Dentistry)

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Marriottsville Location

2600 Longstone Ln, Suite 101,
Marriottsville, MD 21104
(410) 442-0103

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Rockville Location

9850 Key West Ave,
Rockville, MD 20850
(301) 838-9300

Rockville (Rockville Smile Design)

Convenient to the I-70 corridor from Washington DC, and Northern Virginia through the Washington DC Suburbs in Maryland and Frederick

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I have been going to South River Periodontics for years. I can't say enough about Dr. Robert Bouffard, DDS. His expertise and chair-side manner are positively beyond compare. I actually enjoy going to the dentist! If you're searching for a fabulous dentist who takes the time to actually get to know his patients and provides the best in dental treatment, one who will also explain procedures to you and treat you with the utmost respect and care, look no further than Dr. Robert Bouffard!

Linda Lee Annapolis, MD Dental Patient

Dr. Bouffard extracted my son's wisdom teeth when my son was only 13 and did such a fabulous job. He took his time to explain the procedure and put my son at great ease. Now my son needs an implant to replace a tooth lost when he was 9 and there is little anxiety since he trusts Dr. Bouffard so much. We are so happy to have met him at Maple Ave Family Dentistry in Barrington.

Eileen Brady Annapolis, MD Dental Patient

I was referred to Dr. Bouffard six months after hitting my face on the steering wheel in a car accident. Although I had been seen several times for face pain since the accident, it was still unclear about what was going on. Dr. Bouffard listened closely to all my continued troubles and within 5 minutes of meeting me figured out that my upper jaw had actually been dislocated and should’ve been wired shut to heal properly. I was upset but relieved to finally have some answers and a solid plan for treating my pain. Dr. Bouffard worked with one of "his guys" to construct a splint that I wore for several months to provide support and structure for my healing jaw. He has continued to be involved in my healing process, performing two implant surgeries and sending me on to an orthodontist for braces to further strengthen the integrity of my jaw. Two years later, he continues to check in with me and show genuine concern about how I am feeling. I am truly grateful to have been referred to him.

Laura Petersen Annapolis, MD Dental Patient

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104 Forbes St, Suite 204, Annapolis, MD 21401
310 Maple Ave, Suite 107, Barrington, RI 02806
9850 Key West Ave, Rockville, MD 20850
2600 Longstone Ln, Suite 101, Marriottsville, MD 21104