Name of the Procedure:

Subepithelial Connective Tissue Graft Procedure (D4273)

Summary

A Subepithelial Connective Tissue Graft involves transplanting connective tissue from the roof of the patient's mouth to areas in the mouth where gums are receding. This helps restore and thicken the gum tissue over the exposed root surfaces of the teeth.

Purpose

This procedure addresses gum recession which can lead to root exposure, increased sensitivity, and higher risk of decay or tooth loss. The goal is to cover the exposed roots, reduce sensitivity, and improve the overall appearance and health of the gums.

Indications

• Significant gum recession exposing tooth roots.
• Teeth sensitivity due to root exposure.
• Aesthetic concerns due to uneven gumline.
• Insufficient gum tissue due to periodontal disease.

Preparation

• Fasting may be required if sedation is involved.
• Patients should disclose all medications and supplements they are taking.
• Pre-procedure assessments might include dental X-rays and a thorough examination of the gums and teeth.

Procedure Description

1. Anesthesia: Local anesthetic to numb the treatment area, with sedation options if needed.
2. Tissue Harvest: A small incision is made on the roof of the mouth to access and remove a small piece of connective tissue.
3. Graft Placement: The harvested tissue is placed and sutured over the area of gum recession.
4. Stitching: The donor site on the roof of the mouth is then sutured closed to heal.

Duration

Typically, 1 to 2 hours.

Setting

This procedure is generally performed in a dental office or outpatient clinic.

Personnel

• Periodontist or oral surgeon
• Dental assistants
• Anesthesiologist (if sedation is used)

Risks and Complications

• Common: Swelling, bleeding, and discomfort at the graft and donor sites.
• Rare: Infection, graft failure, excessive bleeding, and reactions to anesthesia.

Benefits

• Reduced tooth sensitivity
• Improved aesthetic appearance
• Enhanced gum health
• Prevention of further gum recession

Recovery

• Patients may need to follow a soft-food diet for a few days.
• Avoid strenuous activity and brushing the treated area for a specified period.
• Pain management may include prescribed medication or over-the-counter pain relief.
• Sutures may need to be removed in a follow-up appointment.
• Full recovery typically takes a couple of weeks to a month.

Alternatives

• Scaling and Root Planing: Less invasive but might not be sufficient for severe cases.
• Gum Regeneration: Less common and more complex, involving the use of membranes and growth factors.
• Pinhole Surgical Technique: Minimally invasive but newer and less widely available.

Patient Experience

Patients may feel pressure during the procedure but no pain due to anesthesia. Post-procedure discomfort can be managed with pain relievers. Initial swelling and bleeding are common but typically subside within a few days. Most patients can return to normal activities within a week, following their dentist's specific instructions and care guidelines.