A member asked:

Periodontist: which soft tissue graft will provide gingival re-atachment to the tooth root vs. only a tight collar? want to build height.

7 doctors weighed in across 5 answers
Dr. Alexandra Jaquery answered

Specializes in Cosmetic Dentistry

Your own connective : Connective tissue from your palate is the most friendly. The procedure isntechnique sensitive. Be sure tomgo to a skilled specialist in periodontics.

Answered 3/12/2013

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CT graft : Ct grafts are ideal to cover root surfaces or increase tissue height and thickness. Over exposed cementum (root surfaces), it forms a new connective tissue attachment. If the goal of the procedure is to cover root surfaces, interproximal bone heigh plays a key role. If there is loss of interdental bone and papilla, complete root coverage is unlikely.

Answered 3/12/2013

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Dr. Scott Bobbitt answered

Specializes in Dentistry

Depends: Upon level of tissues around the tooth. Google "miller' classification oh gingival recession defects". Both "free gingival" and "sub epithelial connective tissue" grafts will restore attachment via hemi-desmosomal connection--a "tight collar" if kept clean and maintained. "guided tissue regeneration" can restore actual ligament attachment in some cases. You may not get to choose! seek a consult.

Answered 12/9/2013

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Dr. Gary Sandler answered

Specializes in Dentistry

GOK: I suggest to you that there is no one "best" procedure. It is case dependent, tooth dependent, periodontist dependent and some luck of the draw. I have often discovered that what i don't expect to work sometimes does, and what should work sometimes comes up short. I also recommend that a patient find a dentist that he\she trusts and then listen to their recommendations. That’s what i do.

Answered 3/13/2013

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Dr. Gregory LaMorte answered

Specializes in Periodontics

Gum height: The limiting factor for what you want is the height of the gum between your teeth. The graft over the root can never be higher than the top of the gum on either side of the tooth getting the graft. Given that premise, a connective tissue graft may give the most root coverage, but a lot depends on the experience and expertise of the surgeon.

Answered 1/1/2015

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