Advances in plastic and reconstructive surgery allow us to rebuild tissue in areas of gum recession.  There are typically three predisposing factors to gingival (gum) recession. They are infection, thin tissue and thin bone. Infection (see section on Periodontal Disease) will destroy the tissue and the bone. Very thin tissue and bone is often seen in some orthodontic patients and provides very little protection to the roots. It is important to reconstruct the lost tissues in order to prevent further recession and where possible to cover the exposed roots. In some situations such are advanced orthodontics or tooth restorations that will involve the gum tissues we may want to reconstruct the tissues before there is recession in order to prevent loss of tissue and bone. Keep in mind that an exposed root used to have a cover of tissue and bone.

Soft Tissue Grafting, Before Tissue Reconstruction
Before Tissue Reconstruction
One Year After Reconstruction
One Year After Reconstruction

Gum Recession

Gum recession often results in root sensitivity to hot and cold foods as well as an unsightly appearance to the gum and tooth. Gum recession, when significant, can predispose to worsening loss of support and further expose the root surface, which is softer than enamel, leading to root caries and root erosion.

Soft tissue reconstruction is designed to solve these problems. Utilizing a Minimally Invasive Surgery, a thin piece of tissue is taken from the roof of the mouth, or gently moved over from adjacent areas, to provide a stable band of firm tissue around the tooth. The gingival graft may be placed in such a way as to cover the exposed portion of the root.

The gingival graft procedure is highly predictable and results in a stable healthy band of attached tissue around the tooth.

This case was originally published by Dr. Cabrera in the Journal of the American Dental Association. June 1995:

Before Tissue Reconstruction
Soft Tissue Grafting, After Reconstruction
After Reconstruction

Treatment Methods

Whereas older procedures involved large incisions, the procedures we have used in our office for several decades are classified as Minimally Invasive Surgery. Much of the work is accomplished through small openings that significantly reduce patient discomfort and leave a much more esthetic result.

Case Study- Combining procedures

In the past certain problems required several surgeries to properly reconstruct the tissues. By combining several steps into one procedure we are now able to accomplish the same results with only one surgery. (the technical term is connective tissue grafting with labial vestibular extension)

This approach  was originally published by Dr. Cabrera in the Journal Practical Periodontics and Esthetic Dentistry. June/July 1995

Periodontal Cosmetic Surgery

If you are unhappy with the appearance of short unsightly teeth this can be greatly improved by a combination of periodontal procedures by Dr. Cabrera and cosmetic dentistry by your dentist.

Although your teeth appear short, they may actually be the proper length. The teeth may be covered with too much gum tissue. We can correct this by performing the periodontal plastic surgery procedure, crown lengthening.

During this procedure, excess gum and bone tissue is reshaped to expose more of the natural tooth. This can be done to more than one tooth, to even your gum line, and to create an attractive smile.