Gum Grafting (Connective Tissue)

When recession of the Gingiva (gums) occurs, the body loses a natural defense against both bacterial penetration and trauma. When gum recession is a problem, gum reconstruction using grafting techniques is an option.

When there is only minor recession, some healthy Gingiva often remains and protects the tooth, so that no treatment other than modifying home care practices is necessary. However, when recession reaches the mucosa, the first line of defense against bacterial penetration is lost.

In addition, gum recession often results in root sensitivity to hot and cold foods as well as an unsightly appearance of the gum and tooth. When significant, gum recession can predispose to worsening recession and expose the root surface, which is softer than enamel, leading to root caries and root gouging.

A gingival graft is designed to solve these problems. The gingival graft may be placed in such a way as to cover the exposed portion of the root. It is highly predictable and results in a stable healthy band of attached tissue around the tooth.

A gum graft covers the exposed root of a tooth, protecting and stabilizing it.

 Orthodontics & Periodontics - Receding Gums Before  Orthodontics & Periodontics - Receding Gums Before 2
 Orthodontics & Periodontics - Receding Gums After  Orthodontics & Periodontics - Receding Gums After 2


A thin piece of connective tissue can be taken from the roof of the mouth to provide a stable band of attached gingiva around the tooth.



A frenum is a fold of tissue or muscle that connects the lips, cheek or tongue to the jawbone.  Often it is located right between the upper front teeth contributing to a gap.  A frenectomy is a procedure to remove one of these folds of tissue. Sometimes a frenum can be attached too high on the gums causing either recession or spaces between teeth. The frenectomy procedure involves the removal of the tissue attachment between the two front teeth as the gap between the teeth can again be pushed apart by the frenum, even after it is initially corrected with orthodontic (braces) treatment.

By removing excess connective tissue Dr. Ciniglio can enhance your smile.

 Orthodontics & Periodontics - Frenectomy Before
 Orthodontics & Periodontics - Frenectomy After


Tooth Exposure

Sometimes permanent teeth get impacted (stuck in the bone) and need to be uncovered. The Maxillary Cuspid (upper eye tooth) and Mandibular premolars (lower side tooth) are the most common teeth to become impacted, excluding wisdom teeth. The Cuspid tooth is a critical tooth in the dental arch and plays an important role in your “bite”. They are designed to be the first teeth that touch when your jaws close together so they guide the rest of the teeth into the proper bite.

The Maxillary Cuspid and Mandibular premolar teeth are the last teeth to erupt into place around age 12. If a tooth IS impacted, every effort is made to get it to erupt into its proper position in the dental arch.

In a simple surgical procedure performed in Dr. Ciniglio’s office, the gum on top of the impacted tooth will be lifted up to expose the hidden tooth underneath. If there is a baby tooth present, it will be removed at the same time. Once the tooth is exposed, Dr. Ciniglio will bond an orthodontic gold button to the exposed tooth. The button will have a miniature gold chain attached to it. She will guide the chain back to the orthodontic arch wire where it will be temporarily attached until the orthodontist is seen. Sometimes Dr. Ciniglio will leave the exposed impacted tooth completely uncovered by suturing the gum up high above the tooth or making a window in the gum covering the tooth.