Soft tissue grafting
Gum grafting in Downtown Brooklyn
A gum graft is a periodontal procedure that adds healthy gum tissue to a tooth or implant where the gum has receded, covering the exposed root, reducing sensitivity, and building a durable collar of tissue that resists further recession. At Brooklyn Periodontics we graft with your own tissue, supported by PRF made from your own blood, and we use the least invasive technique that will hold, including the pinhole surgical technique when a case allows it.
Recession is not just cosmetic. An exposed root is softer than enamel, decays more easily, and often cannot be restored predictably once the gum line keeps moving. Grafting stops that progression.
What is a gum graft?
Gum grafting, also called soft tissue grafting, replaces gum tissue that has thinned or pulled away from a tooth or implant. Since 2014 we have used your own tissue for this in nearly every case: a connective tissue graft taken from your own palate, supported by PRF made from your own blood.
Once healed, the grafted tissue behaves like your own gum, because it is your own gum: thicker, better attached, and far less likely to recede again.
Your own tissue versus a donor matrix
The convenient alternative is a processed donor matrix, a sheet of sterilized human or animal tissue that avoids a second site on the roof of your mouth. It is the soft tissue version of what clinicians call bone in a bottle: a scaffold with no living cells, which your body has to populate and remodel into gum of its own.
Your own connective tissue arrives already alive, with its own cells and blood supply, and it keeps the character of the tissue it came from. That is why it has been our default for more than a decade, and why we accept the small palatal donor site as part of the trade.
Donor matrix is not wrong, and there are cases where it is the sensible choice, for example when many teeth are treated at once or when a patient's palate cannot supply enough tissue. We will tell you plainly which we are recommending for you and why.
PRF: your own blood, used to heal
PRF stands for platelet rich fibrin. A small amount of your blood is drawn at the start of the visit and spun in a centrifuge here in the office, which concentrates your own platelets and growth factors into a soft natural membrane.
That membrane goes into the surgical site and over the palatal donor area. Nothing is added to it, there is nothing synthetic in it, and it is used to support healing in both places.
We follow the advanced PRF protocols developed by Dr. Joseph Choukroun in France, who originated the technique. Spin speed, timing, and handling change what ends up in the membrane, so we follow a defined protocol rather than improvising.
Who is a candidate?
We measure recession, tissue thickness, and bone level at the consultation. Grafting is usually recommended when:
The root is exposed and sensitive
Cold air, brushing, or cold drinks hurt at the gum line, and the notch on the root is getting deeper year over year.
Recession is progressing
Photographs or your dentist's charting show the gum line moving over time, even with good brushing.
The tissue is too thin to survive
Thin, translucent tissue with no attached gum will not hold up against brushing, a filling margin, or orthodontic movement.
An implant or crown is planned
Adding tissue before restorative work protects the margin and the long-term appearance of the crown.
Tissue is receding around an implant
Implants show through thin tissue as a grey shadow. Grafting can thicken the collar and cover the metal.
How the procedure is performed here
Almost every graft is a single visit under local anesthesia, usually 60 to 90 minutes.
01
Diagnosis and technique selection
We chart recession depth, tissue thickness, and the cause. If the pinhole surgical technique will work for your pattern of recession, we use it: one small entry point, no incisions, no sutures.
02
Site preparation
The root surface is cleaned and smoothed so the new tissue can attach to it, done under magnification for precision.
03
Graft placement
Your own connective tissue, supported by your PRF membrane, is placed and secured over the recession, often across several teeth in one sitting. A donor matrix is used only in the cases where it is the better option for you.
04
Healing check
You are seen at about one week and again at three to four weeks. Most patients return to normal eating within a few days.
Recovery and what to expect
Expect mild soreness and swelling for two to three days, controlled for most patients with over-the-counter medication. When tissue is taken from your palate, that donor area is covered with your own PRF membrane and is typically the part that feels tender for the first few days.
You will eat soft food and avoid brushing the graft for about two weeks, rinsing instead. Tissue looks settled at four weeks and reaches its final contour over a few months.
You leave with written instructions and a direct line to the doctor on call at (718) 643-1953.
Why see a periodontist rather than a general dentist
Soft tissue surgery is one of the core procedures of periodontal residency. Dr. Zidile and Dr. Choi each completed three years of surgical specialty training in periodontics and implant dentistry at NYU and are board certified in the specialty.
Technique choice is what determines whether a graft holds for twenty years. A specialist who performs these weekly can tell you which recession is stable and can be watched, and which will keep moving without treatment.
Alternatives and least invasive options we consider first
Not all recession needs surgery. If the cause is brushing technique, a high bite, clenching, or a restoration margin, we correct that first and re-measure. Stable recession with adequate thickness is monitored with photographs, not grafted. When grafting is needed, the pinhole technique is offered whenever the anatomy allows because there is no incision and no suture.
Questions patients ask
Gum grafting questions
- Is gum grafting painful?
- The procedure itself is done under local anesthesia and you should not feel it. Afterwards most patients describe soreness rather than pain, managed with over-the-counter medication for two to three days.
- Do you have to take tissue from my palate?
- Usually yes, and that is intentional. Since 2014 we have grafted almost exclusively with your own tissue, because living tissue from your own mouth integrates as gum rather than having to be remodeled into it. The palatal site is small, covered with your own PRF membrane, and heals within a couple of weeks. A processed donor matrix is used in the cases where it is genuinely the better option, and we tell you which we are recommending before you agree to anything.
- What is PRF and do you use it?
- PRF is platelet rich fibrin. We draw a small amount of your blood, spin it in a centrifuge in the office, and place the resulting natural membrane of your own platelets and growth factors into the graft site and over the palatal donor area. Nothing is added to it. We follow the advanced PRF protocols developed by Dr. Joseph Choukroun in France.
- Is my own tissue better than a donor graft?
- Your own connective tissue comes with living cells and its own blood supply and keeps the character of the tissue it came from, which is why it is our default. Donor matrix products are well documented and useful, particularly when many teeth are treated at once or when there is not enough palatal tissue available. The honest answer is that both work and we start with yours.
- What is the pinhole surgical technique?
- It corrects recession through one small entry point instead of incisions. The existing gum is loosened and repositioned over the exposed roots, and collagen is placed to hold it. There are no scalpels and no sutures, and results are visible immediately.
- How long does a gum graft last?
- A successful graft is permanent tissue. Long-term stability depends on removing the cause, so brushing technique, bite forces, and grinding are addressed as part of treatment.
- Will the graft cover the whole exposed root?
- Complete root coverage is realistic in many cases and partial coverage in others, depending on how much bone remains between the teeth. We tell you which outcome to expect before you agree to treatment.
- Can gum recession be reversed without surgery?
- Lost gum tissue does not grow back on its own. Non-surgical care can stop recession from worsening, but coverage of an exposed root requires a graft.
- How much does gum grafting cost in Brooklyn?
- Fees depend on how many teeth are treated and which technique is used. You receive a written fee and an insurance estimate before scheduling, and we file electronically with your plan as a courtesy.
- Does insurance cover gum grafting?
- Many dental plans provide partial coverage when there is documented recession and sensitivity or root exposure. Our insurance team handles the paperwork, submits the documentation, and tells you your expected out-of-pocket first.
- Can you graft around a dental implant?
- Yes. Thin tissue around an implant is common and treatable. Grafting can thicken the collar, cover a grey shadow, and protect the bone underneath.
- How soon can I go back to work?
- Most patients work the next day. Strenuous exercise waits about a week.
Related
Non-surgical gum treatment
The conservative therapy we start with before any surgical option.
Bone grafting and sinus lift
Rebuilding the bone underneath when the ridge has shrunk.
Periodontitis treatment
Stopping the disease that causes tissue and bone loss.
Second opinion
Have a graft or surgery quoted elsewhere? We will review it independently.
Gum line moving, or a root that hurts?
Send us a message or request a consultation. We will measure it, tell you whether it needs treatment now, and put the plan in writing.