Gum tissue grafts come in two forms.
First of all, we use the patient's own gum
which will allow us to take some gum from the palate
which is good, thick, hard tissue
and also has the genetic code to change the tissue wherever you place the graft.
So, it changes any tissue where you place it to the same quality tissue that you have in your palate.
You’ll use it wherever there is, for example, gum recession around teeth
where the roots of the teeth have been exposed
rather than putting a filling on it we first put a gum graft on it
and also, it will be useful where the gum has thinned over time
where teeth have been lost.
We’re talking about a bone graft, but you also need
adequate, soft tissue thickness over the bone graft,
to be able to successfully cover a bone graft so that it heals properly.
The tissue we take from the palate or we can also use proprietary collagen from animals
that have been processed in a certain way
to bulk out the tissue and to cover areas that have been previously exposed by the teeth
It depends. I mean, the surgery itself is, you know, an hour or two.
But the healing time needs to be a little bit prolonged.
So we are looking really at least 8 to 12 weeks
of soft tissue healing before it becomes anyway near
mature enough to be able to brush and eat properly.
During that time, you have to be very careful with it
you have to not scrub it with a brush,
you have to be careful not to traumatise it
and this takes time for that tissue to mature into something that is able to function.
But it is very predictable;
if you get it right you can actually augment quite a large area of tissue.
The nice thing about the palate is that the palate tissue
will then regenerate and if you need to go back a few months later
or a year later, you can take more tissue from the palate
and it will just keep regenerating, giving you
what's required for different areas of the mouth.
If it is required, it’s suitable for you
and because very often we use your own tissue
then there is no problem with using a different product.
There is some soreness in two sites;
of course, in the surgery site and the donor site in the palate
but once they heal, they work very nicely.
If we are using very large areas,
or over bone grafts,
then using proprietary collagen, which can come in bigger sheets,
is a better idea and obviously stops you from requiring
your own tissue being harvested from the palate.
But for some areas, the palate tissue is better
and it depends on the individual site
that we are treating which we use.
It’s very effective. If you have lost tissue,
replacing it with your own tissue or a graft
is very effective and you will get extra volume,
you'll get stability, you’ll get better appearance,
and ... the nature of the tissue will change
so that it's tougher and more resistant to future recessions.
The downsides are, of course, that because you are relying on a piece of tissue
that you are taking from somewhere and putting it somewhere else
that tissue has to regenerate its own blood supply and
develop its own blood supply and if the surgery is unsuccessful,
you can lose the tissue, so if it gets traumatised,
or if it doesn’t work then you can actually end up with
a result that is slightly worse than you started off with.
And again, it depends on the site as to how severe this might be.
We will tell the patient what the risks are but, on the whole,
You know, 95 percent of cases, you’ll get additional tissue
and it will become more stable over time.
[inaudible]
It’s like any surgery, I mean most surgery in the mouth will also heal at the same rate.
Regardless of the scope of the surgery,
even if it's one site or a full mouth,
the speed of recovery is actually the same
because all of the tissues are healing at the same time at the same rate in a certain way.
You can’t really speed up and
there are certain medical conditions that will slow it down,
for example, if you are a smoker, or you are a diabetic,
or you have reduced vascularity in the area,
Then they will compromise the result and in some cases,
we would probably advise the patient that it's probably not worth doing
because the rate of success is much lower in these cases.
But if you are a healthy patient with a good blood supply,
and everything heals normally, then everything heals regardless of the site
and usually, there’ll be about a week of discomfort.
We take sutures out normally in about two weeks but it takes about 6 to 8 weeks for the tissue to mature enough
for it to feel comfortable enough to brush properly.
The longer you leave it, the better it gets.
When you look at gum grafts 2, 3, 4, 5 years down the line, you find that the tissue actually gets even better with time,
change the genetic underlying code for the tissue,
that means the new tissue that’s regenerated over time
as your body turns over is actually a better quality than you had at the start.
So, there’s a long-term benefit, not just a short term benefit
that actually improves with time and matures with time.