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Cosmetic Periodontics Gum grafting

Periodontal Cosmetic PLASTIC Surgery

Cosmetic surgery of the gums can help enhance the symmetry and esthetics of your entire smile. It lays the foundation for cosmetic dentistry by your general dentist.

In some people teeth appear short and covered up by too much gum. In others gum may recede, making the teeth look longer and more sensitive to hot or cold foods. Sometimes your general dentist or orthodontist needs a better gum or bone foundation for their work.

Ask Dr. Hoffmeyer for a smile consultation. She can use her artistic vision and knowledge in different modern periodontal plastic and aesthetic procedures to sculpt your gum tissue, make your smile beautiful and work towards achieving the look you want!


The gums may have receded for a number of reasons. These include aggressive tooth brushing, periodontal disease, orthodontic movement or problems with your occlusion (bite).

Dr. Hoffmeyer will help you identify the contributing factors and advise you how to control these factors. It is important in order to help prevent new or further recession of your gum and bone loss. This will be done prior to any soft tissue grafting procedure.


If you have a "gummy" smile or uneven gum line, crown lengthening can help your teeth to look longer and more even. This procedure removes the excess gum tissue and exposes more of the crown of the tooth.





Soft tissue grafts can be used to improve your smile, cover roots and develop gum tissue where absent, e.g.:

  •   Cover exposed roots or implants due to gum recession that make the tooth look too long.

  •   Make implants, crowns, bridges and dentures look natural around the gum-line.

  •   Prevent food trapping in the gum and recession around implants and teeth.

  •   Protect roots from decay

  •   Prepare roots for orthodontic treatment when the gum is too thin.

  •   Repair gum that has receeded after orthodontic treatment

  •   Reduce tooth sensitivity to hot or cold foods and liquids

  •   Improve the esthetics of you smile.

A tooth is normally surrounded by pink, thick, dense gingiva (gum) that forms a tight seal and barrier against bacterial access to the underlying bone. When recession occurs on a tooth this pink gingival seal becomes narrower or disappears. Instead the soft, red, thin and loose tissue (mucosa) found adjacent to the gingiva now acts as a loose seal around the tooth, not withstanding trauma very well. The natural defense against bacteria and trauma is reduced.

When minor recession in healthy gingiva occurs, it is most likely treated by changing oral hygiene procedures. When recession reaches to the mucosa (soft, red tissue) a gingival graft procedure is performed.

A little piece of gum tissue is taken from your own mouth (e.g. palate) or from another donor source and covered over the exposed root. Sometimes tissue can be gently moved over from adjacent areas. These procedures can be done for one or several teeth. This procedure results in a stable healthy band of attached gum tissue around the tooth.

Gum grafting to cover exposed roots


Lower front teeth show red, inflamed, loose receeding gum and plaque buildup.

Grafting this area is very difficult.

The primary goal is to prevent further gum loss and build-up a zone of healthy pink gum.


"Black triangle" between front teeth is a cosmetic problem to the patient.

Gum grafting reconstruction of lost papilla (gum between teeth).


Tooth (left), implant (middle), tooth build-up (right).

The tooth has 2-3 mm pink, firm gum. The implant and tooth build-up has less than ½ mm pink, firm gum. The present red, movable (mucosa) tissue may cause a food trap or recession of the gum (left photo).

Gum grafting creates a wider pink, firm gum (right photo)







When getting a crown, the general dentist must prepare your tooth to receive the crown. Sometimes there is not enough tooth structure above the gum-line to accomplish this. This can be due to decay, fracture or a worn down tooth.

In order for gum tissue to attach on the tooth there must be 3 millimeters of healthy tooth between the margin of a crown and the bone. If not red, irritated gum and bone loss can be seen following crown placement. This gum condition is called "Violation of Biological Width".

Crown lengthening provides more tooth for your crown, it ensures a more stable crown and allows for less gum irritation afterwards. Crown lengthening is highly predictable if carried out correctly.


before after Crown lengthening was performed to expose more tooth surface.

A tooth colored crown can now be placed instead for the amalgam filling.

Crown lengthing was performed to expose the broken tooth roots and avoid tooth removal.

Crowns were placed and a beautiful smile restored


periodontal surgery duration:

Frenectomy only takes approximately 15 minutes and self-desolving sutures are used. This procedure can be done by laser as well.

Most other periodontal surgeries take approximately 1-1½ hour depending on severity and extent.
Suture removal: 15 minutes at 7-14 days after surgery.
Follow-up visits: 15 minutes at 3 and 5 weeks after surgery.
Re-evaluation of procedure outcome: 3-12 months after surgery depending on procedure.

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