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Video Details
The Free Gingival Graft...Back to Basics: Why Do It?

Description:
The lower incisor area is the site of the most common mucogingival deficiencies: Gingival recession, high frenum attachments, and thin tissue. Because of the local anatomy, this area is a challenge to treat surgically. Common treatment options often include the subepithelial connective tissue graft, acellular dermal graft, free gingival graft, as well as several other methods/materials. In this video, a free gingival graft is demonstrated to address a recession defect as well as to augment the soft tissue while eliminating the high frenum pull in order to aid in the orthodontic treatment plan of a young patient. While commonly shunned for the morbidity associated with palatal grafts, the free gingival graft is making a comeback with the popularity of implant dentistry due to it's relative simplicity and predictability for augmenting thin tissue. This "back to basics" video takes the free gingival graft back to its roots: The lower incisor area.

Date Added:
10/13/2012

Author(s):

David Wong, DDS David Wong, DDS
Dr. David Wong is a board-certified Periodontist in private practice in Tulsa, Oklahoma.

Dr. Wong received his undergraduate education and dental training at the Un...
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Online Videos / Surgery / Periodontic Surgery / The Free Gingival Graft...Back to Basics: Why Do It?




Questions & Comments
david wong - (4/18/2014 10:38 AM)

I second what Dr. Salama says regarding periodontal dressings. I also rarely use a dressing. For my typical free gingival graft such as this, I typically do not suture the bottom portion of the graft to the periosteum IF the graft is immobile. If I am uneasy about the graft's stability I will utilize a periosteal anchoring sling suture that more firmly adapts the graft to the recipient bed.

Maurice Salama - (4/16/2014 9:28 PM)

Helena; Not always, only to help extend the vestibule. Dr. Salama

Helena DeLuca - (4/16/2014 8:28 PM)

Thank you for your great presentations! Do you use periodontal dressing with your FGG'S?

Maurice Salama - (4/16/2014 4:26 PM)

Helena; Barricade is Light Cured Material and very popular or you can you select Perio Pak. Dr. Salama

Helena DeLuca - (4/16/2014 4:23 PM)

WHICH PERIODONTAL DRESSING IS BEST TO USE WITH FREE GINGIVAL GRAFTS, THANK YOU

Spencer Sarue - (2/16/2014 6:44 AM)

Excellent video. Thanks for posting it

Charlie Chen - (3/29/2013 5:05 PM)

Dr.Wong, I also have the same question as Hector. I notice you did not suture the bottom portion of the graft to the periosteum. I would think it would lead to increase in mobility of the graft, especially if the patient move his/her lip. Wouldn't suture the bottom portion of the graft to the periosteum be more secure?

saadou khalaf - (12/26/2012 3:46 PM)

thank u very much dr wong, my question , is it important to cover the site with a perio pack

david wong - (11/4/2012 12:44 AM)

Thanks, Ryan! And yes, we are assuming that with orthodontic treatment the gingival levels will become equal. In regards to this procedure, the graft ended up covering the root up to the CEJ. The CEJ is the coronal/incisal limitation of the tissue height, as grafts will not attach to the enamel. This is why the graft was placed in the position that it was placed. Alternately, lengthening #25 would not be an option because the root would become exposed. Hope that helps... thanks for watching!

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