Gum Plastic Surgery (Gingivoplasty)

Gum plastic surgery (or gingivoplasty) is a procedure performed on the soft tissues (mucous membrane) of the oral cavity in the gum area. It is carried out when the qualitative or quantitative characteristics of the gum around the teeth or implants are compromised.

Normally, the gum consists of fixed (attached) and mobile parts. In the area adjacent to the teeth, the gum is fixed, fused with the periosteum, tightly fits the bone and tooth necks, does not form pockets, does not bleed, and has a pale pink tint.

Gingivoplasty is necessary if:

The gum is too mobile around the teeth.
Tissues have atrophied, leading to gum recession (exposed roots).
There is an excess of gum tissue due to incomplete tooth eruption (“gummy smile”).

The objective of this surgical manipulation is to restore the quality and quantity of gum tissue, thereby changing the gum biotype.

How is the gum plastic surgery performed?
The procedure is carried out on an outpatient basis under local anesthesia or sedation. In 95% of cases or more, the patient’s own tissues are used for this manipulation.

Donor zones include:

Maxillary tuberosity. The tissues in this area are rich in collagen fibers; harvesting a graft from the tuberosity zone and subsequent healing are practically painless.
The palate (roof of the mouth). Used less frequently when there is a tissue shortage. Healing is slower, and the patient may experience discomfort while eating or speaking for 1–2 days after the intervention.
Retromolar space. Used very rarely, as collagen-rich tissue is less common in this area.

With gum recession coverage, we achieve not only an aesthetic effect but also the prevention of wedge-shaped defects. When gingivoplasty is performed in the implantation area, blood supply to the bone tissue around the implant improves, which is the key to its long-term service.

Bone Grafting (Osteoplasty)

Bone grafting (osteoplasty, sinus lift, bone augmentation) is a surgery to increase bone tissue volume, allowing for the creation of sufficient space for implant placement.

The dental implantation concepts All-on-4 and All-on-6 allow for the restoration of the dentition without bone grafting in most clinical situations. However, if volume augmentation is indicated, one of the following methods is applied:

Sinus lift (only for upper jaw implantation) — the floor of the maxillary sinus is raised through an incision in the gum and bone and filled with artificial bone material.
Osteoplasty — grafting natural or artificial material from a donor (human or animal) under the gum or into the alveolar ridge.
Autogenous transplantation — grafting a block of the patient’s own bone to increase volume in both height and width.