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If you’ve recently been told by your dentist or periodontist that you have gum recession and their recommendation is pinhole gum surgery to cover exposed roots, reduce sensitivity and the risk of root decay you may have some questions about the procedure.
This post explains what Pinhole Gum Surgery is and answers your queries about this gum grafting procedure.
What is Pinhole Surgery?
Pinhole gum surgery, (also known as the Pinhole® surgical technique and Pinhole Gum Rejuvenation®), is a minimally invasive discomfort-free procedure that’s been shown to provide dramatic results for patients with gum recession (also called gingival recession). The procedure involves making a tiny pinhole incision and repositioning your existing gum tissue to cover the exposed tooth root.
What Happens During the Procedure?
During the procedure, a small entry point is made in your gum tissue using a needle. Next, an instrument called an “elevator ” is inserted to loosen the gum tissue. The gum tissue is repositioned over the tooth and collagen strips are placed over each tooth to secure the tissues.
The procedure has been described as quick, easy and instantly pleasing.
Recovery From Pinhole Gum Surgery
The recovery time from surgery is quick. There’s little downtime and you’ll typically be back to your usual routines within 24-48 hours.
You may experience some sensitivity, but by the same evening, most patients feel comfortable enough to start eating again. Patients experience little pain but there can be considerable swelling which will subside after about seven days.
The collagen membrane is slowly resorbed over the following three to four months, and the new tissue settles and fully heals.
Surgery has immediate cosmetic results and as there is usually only minimal discomfort you will benefit from your beautiful new smile straight away.
How Does Pinhole Gum Surgery Differ From Traditional Gum Grafting?
Other gum grafting techniques are more invasive as they require the removal of donor tissue from the palette or other areas of the gum to cover the exposed tooth root. The tissue needs stitching into place until the area is healed. Patients often have two areas that need to heal – the donor site and the treated area.
The Advantages
Pinhole gum surgery, when compared to other gum grafting techniques, has the following benefits.
- More comfortable for the patient after treatment
- No cutting
- No stitches or sutures
- Virtually no downtime for the patient
- Quick – the procedure can often be completed within an hour
- Faster recovery than traditional grafting
- No need to take donor tissue from the patient’s palate which means reduced discomfort, pain, bleeding and swelling. There is also a reduced risk of infection
- Excellent, natural-looking, long-lasting results
How Successful is Pinhole Surgery?
Pinhole surgery has extremely high success rates. A review in the Journal of Indian Society of Periodontology found that root coverage was successful in 96.7% of cases after 6 months. It also found that 95% of surveyed patients were highly satisfied with the aesthetic outcome of their treatment (2). This is an equivalent success rate compared to the traditional gum grafting method.
How long does the surgery take?
There has only been one peer-reviewed review that looks at how long the restored gums last after pinhole surgery. The study demonstrated the stability of PST results over a period of nine years. The key to the successful reversal of gum recession is following advice to prevent gum recession from occurring (see our advice on this below).
How Much Does It Cost?
The cost will largely depend on the severity of your case. As case complexity and the number of areas requiring treatment increases so do the fees.
Prices found online from surgeons in the USA suggest that the cost of pinhole gum surgery can range anywhere from $1500 for treatment in one quadrant to $5,000 when a full jaw requires treatment. The average cost appears to be around $3,000.
Will I Be A Candidate For Pinhole Gum Surgery?
Most healthy patients with mild gum recession are good candidates for pinhole gum surgery. Successful candidates will be free of periodontal disease and inflamed gums. Non-smokers, who are committed to developing and maintaining oral hygiene that’s first class will be great candidates.
Who Isn’t Suitable for Treatment with this treatment?
Like all surgical techniques, there are limitations to the success of this treatment.
The following patient groups may have compromised healing and an increased risk of complications.
- Unhealthy patients
- Heavy smokers
- Uncontrolled or poorly controlled diabetes
- Some medications
- Compromised immune system
- Poor oral hygiene
- Active periodontal disease or severe gingival inflammation
- Active tooth decay
- Severe gum recession
- Less than 2-3mm of attached gums
If any of these risk factors apply to you, you may not be suitable for treatment and management of a misaligned bite or bruxism (tooth grinding) will be required prior to surgery.
Alternative Treatments
If you’re not a candidate for this surgery alternative treatment options are available.
Alternative, more invasive soft tissue grafting techniques include
- Free gingival grafts
- Connective tissue grafts
- Pedicle grafts
- Rotational grafts
- Coronally advanced flaps
- Guided tissue regeneration
- Laser-Assisted New Attachment Procedure
When To Call The Doctor
Call your dentist if you experience any unusual symptoms following surgery, including:
- Unexpected pain
- Continuous bleeding or
- Heat from the surgical site
Will I Need Further Pinhole Gum Surgery?
Pinhole surgery will cover exposed roots and protect the area from further recession. However, if the original cause of receding gums is not addressed the area may recede again.
To prevent gum recession from occurring again
- Visit your dentist routinely for checkups and professional teeth cleaning and see your periodontist as needed.
- Eat a well-balanced and nutrient-rich diet.
- Don’t smoke.
- Remove oral piercings
- Maintain excellent oral hygiene
First-class oral hygiene is achieved by brushing the teeth gently using the correct technique and cleaning the interdental spaces with a Gum Pocket Brush, interdental brushes or floss daily.
References
- Pinhole Surgical Technique: Halting gingival recession in a single visit. Dental economics. Available here: https://www.dentaleconomics.com/science-tech/periodontics-and-oral-surgery/article/16387953/pinhole-surgical-technique-halting-gingival-recession-in-a-single-visit
- Reddy SSP. Pinhole Surgical Technique for treatment of marginal tissue recession: A case series. J Indian Soc Periodontol. 2017 Nov-Dec;21(6):507-511. doi: 10.4103/jisp.jisp_138_17. PMID: 29551873; PMCID: PMC5846251. Available here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5846251/
- Beck, Tina M.. “The pinhole surgical technique: a clinical perspective and treatment considerations from a periodontist.” (2018). Available here: https://www.pinholesurgicaltechnique.com/_files/ugd/cc01ec_43421d5600c845ee991951f4b8e3d898.pdf
