A gum graft is a common periodontal procedure designed to restore receded gum tissue, which often exposes the sensitive roots of teeth. This process involves transplanting tissue to cover these exposed areas, protecting the tooth structure and improving the appearance of the gum line. Understanding the visual progression after surgery is important, as the immediate post-operative look differs significantly from the final, healed result. This transformation involves distinct phases, leading to the long-term aesthetic integration of the new tissue.
The Immediate Post-Operative Look
The appearance of the recipient site immediately following a gum graft is temporary, marked by surgical elements and specific tissue coloration. The most noticeable visual sign is the presence of sutures, thin threads used to secure the new tissue in place and stabilize it against the tooth root.
A protective barrier, known as a periodontal dressing, is frequently placed over the grafted area to shield it from trauma. This dressing looks like a putty-like material, typically pink or blue, molded around the teeth. Swelling is also routine, generally peaking around the second or third day, causing the area to appear puffy.
The grafted tissue may initially display a pale hue—whitish, grayish, or yellowish—against the surrounding pink gum. This color change occurs because the transplanted tissue temporarily lacks a direct blood supply, which is necessary for tissue oxygenation. Paleness is expected as the tissue begins to absorb nutrients from the underlying recipient bed.
If the graft tissue was sourced from the palate, this represents a second surgical site. If the outer layer of palatal tissue was removed, the donor site may look like an exposed, ulcerated wound. This area is often protected by a plastic stent or a separate periodontal dressing.
Visual Differences Between Graft Types
The specific type of gum graft dictates the initial post-operative look, based primarily on the source of the transplanted material. A Connective Tissue Graft (CTG) uses the underlying layer of tissue from the palate, leaving the outer layer intact. At the recipient site, the CTG is tucked into a pocket beneath the existing gum, meaning the graft is largely hidden.
Because the CTG is placed under the existing gum flap, the recipient site appears less altered immediately after surgery, offering superior aesthetic potential. The visible gum tissue surrounding the tooth will look slightly bulkier due to the added material underneath. This method prioritizes root coverage and a seamless contour.
Conversely, a Free Gingival Graft (FGG) involves transplanting a full-thickness piece of tissue, including the outer epithelial layer, directly onto the recipient site. This results in a distinct, visible patch of tissue that is often thicker and may appear paler or noticeably different in texture than the adjacent gums.
When using an Allograft or Xenograft, the transplanted material is a pre-processed tissue matrix derived from human or animal sources, respectively. This material is typically placed under a flap of the patient’s own gum tissue, similar to the CTG procedure. The advantage is the absence of a second surgical wound on the palate, and the material is designed to integrate and revascularize, leading to a uniform appearance.
Achieving the Final Aesthetic Result
The ultimate goal of a gum graft is aesthetic integration, where the transplanted tissue blends visually and structurally with the surrounding gums. The initial pale appearance transitions as new blood vessels form (revascularization). This progression starts with the tissue taking on a reddish-pink hue, signaling a successful nutrient supply.
Tissue maturation is a slow process where the new gum gradually changes color and texture to match the adjacent tissue. While initial healing is apparent within a few weeks, the final, stable color and contour can take several months, often three to six months post-surgery. The goal is a natural, non-inflamed pink coloration.
Successful grafts eliminate the recessed appearance that originally exposed the tooth root, creating a smooth, flowing contour. The final texture of the grafted tissue should be firm and dense, similar to healthy gum tissue, offering robust protection to the root surface.
The choice of graft material influences the final color match; CTGs and allografts generally achieve a more seamless color integration. Although the FGG, while highly effective for tissue augmentation, may remain slightly paler or appear patchier, these subtle color variations diminish over time as the body remodels the area. The fully healed gum line provides a visually improved, uniform appearance.