AlloDerm - Autograft vs Donor Graft
While receding gums may seem like a simple problem that affects a patient’s appearance, they can actually cause serious issues. As the gums start to pull back from the teeth, patients can experience increased sensitivity, gum disease, and even tooth loss in severe cases.
An excellent solution for regenerating lost gum tissue and restoring a smile is grafting. Modern dentistry gives patients the option to use their own tissue or donor tissue for the graft. With any treatment, there are various advantages and challenges which should be considered. Patients should work with their dentist to determine which solution will best meet their needs.
Types of Tissue Grafts
An autograft uses soft tissue from the patient’s own mouth. The patient will have the option of completing a free gingival graft or connective tissue graft. While the procedures differ, each graft includes obtaining tissue from the roof of the mouth and attaching it to the area of receding gums and where the tooth’s root is exposed.
During connective tissue grafts, the dentist opens a small flap where a small piece of connective tissue is removed. A connective tissue graft is less invasive compared to a free gingival graft. They also typically have more aesthetically pleasing results. The procedure is highly successful and the tissue closely matches the surrounding gums.
Free gingival grafts do not require the dentist to make a flap. The dentist will harvest inner and outer layers of tissue from the roof of the mouth prior to covering the exposed root. The free gingival graft is ideal in cases where gum recession needs to be thickened or reinforced with additional gum tissue. The color of the free gingival graft is typically more noticeable.
Donor Tissue Grafts
A key advantage of using donor tissue for gum grafts is that the dentist can treat an unlimited number of areas simultaneously. Autografts, however, are only able to address a few areas at once because the tissue harvesting is more invasive. Allografts and xenografts are the two types of donor grafts which are available.
Allograft tissue is harvested from the skin of a cadaver. The tissue is sterilized to remove living cells, proteins, viruses, and bacteria. Once the gum graft procedure is complete, the donor tissue closely matches the patient’s existing gum tissue.
Xenograft tissue is tissue which is harvested from another species. The tissue is usually harvested from cow or pig and is then sterilized. This type of donor tissue also matches well with the patient’s natural gum tissue.
The ideal type of gum graft material will vary based on the patient’s unique needs and situation. The following is a summary of benefits and challenges associated with each material:
Autograft Benefits:
1. Results are predictable with long term success
2. Use of the patient’s own natural tissue
3. Gum thickness can be increased
4. There are two difference sources of blood supply including one from the flap and one from the recipient
Challenges:
1. Patient typically experiences post-procedure discomfort because of the additional surgical site
2. Limited areas of gum recession can be addressed at a time
3. Harvest location and quality can produce varied levels of tissue integrity
Donor Graft Benefits:
1. An entire arch or mouth of receding gums can be treated in a single procedure
2. Patient experiences less discomfort because the graft is not harvested from their mouth
3. A large amount of strong gum tissue can be obtained
4. Existing gum tissue and blood supply is preserved
Disadvantages:
1. Sufficient amount of quality gum tissue is required
2. Patients with teeth which are rotated, inclined or have bone loss are not good candidates
3. Technique is quite challenging and requires advanced training
Patients with concerns over their receding gums should follow up with their dentist to discuss their options. The dentist can help restore the function and appearance of the patient’s smile.