Gum Grafting
Root Coverage That Holds

We begin with precise clinical measurement of every recession site — documenting the amount of recession in millimetres, the width of remaining attached gingiva, root surface exposure, tissue thickness (biotype), and the presence or absence of an adequate band of keratinised tissue. This mapping determines which sites are candidates for grafting, which graft type will be most predictable, and what level of root coverage is achievable. Patients with thin gingival biotype require grafting sooner, before further tissue is lost.

The connective tissue graft (CTG) is the gold standard for root coverage. Subepithelial connective tissue is harvested from beneath the palatal epithelium, then placed beneath a recipient flap at the recession site. This technique reliably achieves 90% or greater root coverage and creates a natural-appearing result. A free gingival graft (FGG), which includes both epithelium and connective tissue, is preferred when the primary goal is to increase the width of keratinised tissue rather than cover the root. We select the technique based on your specific anatomy and goals.

The donor tissue is harvested from the roof of the mouth using careful technique to minimise discomfort and promote rapid healing. A palatal stent may be placed to protect the donor site after surgery. At the recipient site, we prepare a precise bed by elevating a partial-thickness flap at and beyond the recession margin, creating a vascular surface for the graft to adhere to. The root surface is conditioned if indicated to improve graft adhesion and long-term coverage.

The graft is secured with fine resorbable sutures using microsurgical technique to maximise the contact area between graft and recipient bed. The flap is then coronally repositioned over the graft to achieve maximum root coverage. A periodontal dressing or tissue adhesive is applied to protect the surgical site. Detailed post-operative instructions are provided, including soft diet guidelines, oral rinse protocol, and activity restrictions for the first two weeks.

Sutures and dressings are removed at the two-week post-operative appointment. We assess graft take, donor site healing, and initial root coverage. At the three-month follow-up, we measure final recession levels and compare them to pre-treatment records to quantify root coverage achieved. Most patients experience complete or near-complete coverage of exposed root surfaces at this stage. Long-term stability is excellent when combined with proper brushing technique and regular maintenance.