oral health

Are You at Risk of Premature Tooth Loss?

By Kirk W. Noraian, DDS, MS, Periodontist

eceding gums can be a painful, discomforting, and unsightly ailment caused by a variety of conditions. Some individuals who are extremely health conscious may get overzealous with their toothbrushing, and actually strip the gum tissue off their teeth by being too aggressive or using improper technique. Others may be born with thin gum tissue, which may lead to root exposure and sensitivity even with good brushing techniques. As these issues cause the gums to recede, the result is an uneven gum line, which can make you look long in the tooth, make your teeth sensitive or painful to temperature or contact, and even remove the attached gum tissue, which provides a protective seal around the tooth. This root exposure can eventually lead to premature tooth and bone loss. Soft tissue grafting or gum graft surgery will repair the defect and help to prevent additional recession and bone loss by covering exposed roots. To restore the recession of the gums and gum health, soft tissue grafting, where tissue is transplanted over the root of the tooth, is the method of choice. There are several periodontal plastic surgery methods by which the grafting may be accomplished.
Page 14 Healthy Cells Magazine Bloomington September 2013

Palatal Connective Tissue Autograft This early method of grafting harvests the patients own tissue from the palate and transplants it to the affected root surface. While this technique is a good one, it requires making two wounds (one from where the tissue is harvested and one from where it is placed). It is one of the most uncomfortable periodontal procedures during the healing process, and it runs the risk of temporary or permanent numbness of the palate. Also, prior to surgery, an impression is typically taken to fabricate a palatal stent, or covering, which may slightly reduce the discomfort from the palatal wound. Donor Human Dermal Allograft This early method of using donor tissue involves reconstituting human acellular cadaver-sourced dermis, or skin, and transplanting it underneath the gum tissue where the seal is compromised. With only one wound made where the graft needs to be placed, this technique is more comfortable compared to using connective tissue. While the end result looks great, this option is the most unsightly during the healing phase.

Donor Human Amnion-Chorion Allograft This newer method involves placing human acellular placenta tissue underneath the gum tissue where the seal is compromised. This tissue is donated by willing birth mothers who deliver via Caesarean section or sterile surgical delivery. It has been used in eye surgery for over 15 years. This technique offers the benefit of making only one wound where the graft needs to be placed, hence it is more comfortable, and appearance during the healing phase is more like the connective tissue option. Sliding Pedicle Graft This method utilizes special incisions to slide the attached gum tissue from a neighboring tooth, with or without one of the above graft options, to re-establish the seal over the root. Also, any of the methods mentioned may be incorporated into the procedure when needed. While all four methods are predictable, the use of donor tissues has increased because they are more comfortable without compromising the end result. All of the donor tissues mentioned follow the American Association of Tissues Banks (AATB) protocol for safety without disease transmission, and are acellular so the body does not recognize them as foreign, thus eliminating the risk of tissue rejection. The periodontal and dental implant practice of Dr. Kirk Noraian provides stateof-the-art education, examination, and treatment for optimal gum health. Dr. Noraian is also certified to provide and teach Laser Assisted New Attachment Procedure (LANAP), an advanced surgical therapy designed to treat periodontitis which regenerates bone and reduces the discomfort associated with traditional treatments. For more information, visit docperio.com or phone 309-663-4577. After Soft Tissue Grafting

Before Soft Tissue Grafting

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September 2013 Bloomington Healthy Cells Magazine Page 15