Thin Tissue and No Attached Gum on a Lower Tooth, Treated with a Free Gingival Graft
A lower tooth with thin tissue, no attached gum, and a shallow vestibule, the combination that keeps receding. A free gingival graft converted it to a broad, thick band of keratinized tissue. Photographed one month after surgery.
What the Patient Noticed
Recession on a lower tooth that kept getting worse. The tissue was thin, there was no band of attached gum below the tooth, and the vestibule was shallow, so the lip and cheek pulled on the gumline with every movement.
What Was Done
A free gingival graft rather than a connective tissue graft. The goal here was a thick, durable band of attached gum rather than coverage of a root in the smile line, and the free gingival graft was chosen for that reason; the gum grafting page sets out how the two are compared. A piece of surface tissue from the palate was sutured in place below the tooth.
The Result
At one month there is a broad, thick band of keratinized tissue where there was none, and the tissue no longer moves when the lip does, which was the point of the surgery. How a graft behaves over the years afterward depends on the patient and cannot be read from a one-month photograph.