Free Gingival Graft

There are two types of graft procedures:

Root coverage – connective tissue graft

Gingival augmentation – free gingival graft

The gingival augmentation graft, or free gingival graft, is indicated when recession is progressing with time, when there is discomfort during chewing or tooth brushing, and when orthodontic treatment is planned and it is expected that a particular tooth movement may result in recession. A free gingival graft will widen the zone of protective keratinized tissue, which is the non-moving gum that sits next to the tooth. This graft also deepens the vestibule and relieves muscle tension, which helps to prevent the recession from reoccurring.

The free gingival graft involves taking a thin piece of tissue from the roof of the mouth, and attaching it along the root surface of the recipient tooth where the gum tissue is lacking (Figures 1-3). The procedure takes approximately one hour. It may be done with local anaesthetic alone, or in combination with sedation (see “Sedation”). Most patients are back at work two days after having had a free gingival graft. The majority of healing takes place during the first two weeks, and patients may then resume most of their normal eating and oral hygiene practices (see “Post-Operative Instructions”). You will be seen for a 1-week, 2-week and 4-week post-operative check.

The free gingival graft is a highly predictable treatment that helps to widen the zone of protective keratinized tissue around the tooth (Figures 4-5). The graft will also prevent the recession from reoccurring in the future, as long as patients thereafter commit to an atraumatic brushing and flossing technique.