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Gum Diseases

Gum Graft Not Taking Twice

07/21/2010

Question:

I had a grafting procedure 3 years ago on my 2 front middle lower teet (24,25). The doctor did it the way where you get stitches in the roof of your mouth. I had stitches wrapped around my 2 lower teeth, within a couple days one of the stitches around 1 tooth came loose, in the end that graft didn`t take as well as they wanted. Doctor went back in after a few weeks and pulled the tissue up but the recession was still slightly there. Time has passed and my dentist has been telling me go back to the periodontist. A week and a half ago I had the procedure done again by the same person but he cut out the tissue and stitched in onto my gums. Well 1 week after surgery I noticed a wierd spot in the graft tissue so I went in today and he said it didn`t take. He said it may be due to not enough blood vessels in my mouth and I will have to go back in again for the 4th time. I`m getting very tired of this, should I get a second opinon from another doctor? I feel that the first procedure would have worked if that stitch didn`t come undone, could they do it that way again?? He says this is very odd and not normal for this to happen.

Answer:

It is very hard for me to tell you the possible reasons for this negative outcome without seeing you and figuring out what type of gingival recession you had to start with. This procedure is generally very predictable.
 
1- We know that we would have problems with outcome if the patient has major swelling after the procedures. This may affect wound stability.

2- We know that we are very limited in 100% root coverage if the patient has bone loss between teeth.

3- We also have some limitations if the patient does not have enough space to place and suture the soft tissue graft (e.g. anatomically narrow vestibular [cheek] depth).

4- We also know that it does not work very well in smokers.

You can always seek a second opinion before you have a correction surgery.

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Response by:

Binnaz   Leblebicioglu, DDS, MS, PhD Binnaz Leblebicioglu, DDS, MS, PhD
Associate Professor of Periodontology
College of Dentistry
The Ohio State University