Gingival plastic surgery, or gum recontouring, is a surgery to correct, restore or change the gingival contour. This procedure is used both for cosmetic and medical reasons. It solves a very wide range of problems, and, depending on the task, either a part of the tissues is removed or built up.
Gum recontouring allows correction of the zone of one or several teeth or even the entire row; it is carried out both on the upper and lower gums. Accordingly, the price of the procedure depends on the volume and type of intervention.
Use Cases For Gum Recontouring
For cosmetic purposes, gum recontouring may be an option for cosmetic purposes for the following cases.
- The gingival contour is uneven – some teeth are lower, and some are higher. The doctor will determine the optimal level and align the edge accordingly.
- The upper gum in the smile area is too short. In such cases, gum extension may solve the problem.
- The gum line covers part of the dental tissue, which makes the teeth look smaller (the so-called “shark smile”) or protrudes too low under the upper lip (gingival smile). The specialist will remove the necessary amount of tissue to eliminate this defect.
Cosmetic surgery can help when the features of a smile cause significant psychological discomfort to the patient. In addition, plastic surgery may help improve imperfections or even get rid of them.
When Is Tissue Augmentation Necessary?
Gum recontouring surgery in case of root exposure (recession) solves aesthetic and medical issues, protecting this part of the tooth from hypersensitivity, development of tooth decay, and other problems. One of the common causes of recession is periodontitis and gingivitis. A similar problem occurs with a periodontal disease if the gum tissue is too thin due to improper oral hygiene and a number of other reasons.
An extension may also be required when installing an implant – when a tooth is removed, the bone and gum tissue volume decreases over time. Accordingly, if it becomes insufficient for implantation, the tissue is augmented. Sometimes it is necessary to work only on the gingival contour – so that the implant looks as aesthetically pleasing and natural as possible. To cover the bare areas, the doctor cuts tissue and replaces or builds it up with the parts taken from the palate, cheeks, and other areas of the periodontium. Then stitches are applied.
When Is the Tissue Removed?
Removal of tissue is usually associated with big periodontal pockets – another consequence of periodontitis. The normal pocket size is up to 3 mm. As the disease progresses, the pockets enlarge, food debris gets stuck in them, and bacteria multiply, which leads to new inflammations and further enlargement of the pockets. If they become very voluminous, they can no longer decrease to a normal state, and in such cases, surgery is considered the best treatment option.
First, the doctor removes damaged and excessive tissues, then forms the tissue flaps of the desired shape. Then, as a rule, the task of a specialist is to thoroughly clean the problem area and the base of the tooth from bacterial plaque, tartar, etc. After this, it’s safe to put sutures.
Contraindications to the Procedure
Gum recontouring is considered a minor surgical intervention, however, it has a number of contraindications. In particular, the surgery is not performed if the patient has:
- blood diseases, especially clotting disorders;
- uncompensated diabetes mellitus;
- autoimmune disorders in cases in which such surgeries carry health risks;
- acute respiratory, inflammatory, infectious, diseases. However, as soon as they are treated, the procedure is safe.
Before the surgery, it is necessary to sanitize the oral cavity, clean the gum pockets, and get rid of tartar to avoid postoperative complications.
