The Free Gingival Graft
This procedure is to repair a mucogingival defect. The gums are receding from the first lower bicuspid, (see photos below.) In this case the two factors causing the gums to recede are lack of attached keratinized gingivae and muscle pull by the small frenum. The reason for doing this surgical procedure is to prevent further recession of the gums.
There are basically two types of soft tissue lining the mouth. The first is the mucosal tissue which is very elastic and lines the inside of the cheeks and floor of the mouth. The second is the attached keratinized gingivae. This tissue is more robust and durable. It is found on the hard palate and around the teeth. The function of this heavy duty tissue is to resist damage when chewing food that would shred the mucosal tissue
The first surgical step is to incise the small muscle attachment that is pulling on this area and make a split thickness flap. This makes a site or bed for the graft to attach to.
Next a strip of tissue, the graft, is removed from the donor site, the hard palate. The size of the graft is about 15mm X 5mm and 1mm thick
The graft is then placed on the prepared bed and sutured into place and a periodontal dressing is applied to the area.