Aram Lenserovicհ, tell me, how does such a problem as gum recession manifest itself in the early stages and what is it anyway?
 Recession is a loss of gum tissue, which is a consequence of atrophy of gum tissue and bone. Recession can be local, in the area of ​​one tooth, or generalized - covering several teeth or the entire dentition. Patients first of all begin to worry about increased tooth sensitivity and the appearance of the gum. Over time, recession leads to exposure of the outer fragment of the tooth root, and therefore to a number of serious complications - increased sensitivity, loss of attachment of the gum to the tooth and, ultimately, to the loss of the tooth itself. Therefore, recession cannot be considered a purely cosmetic problem.

What are the causes of gum tissue recession?
First of all, it is a genetic predisposition, which occurs in 20-30% of patients. Their gums have a specific structure - they are very thin, with a thinned mucous membrane. Previously, doctors could not do anything about the hereditary factor, but now, by detecting recession or the risk of its occurrence in the future, the patient can be helped. There are other possible causes of gum recession - inflammatory processes, injuries, including from dental floss or aggressive brushing, age-related changes in gum tissue, incorrectly installed orthopedic, orthodontic structures and braces.

What treatment method can be considered the most effective today?
If the problem is detected at an early stage, then the thickness of the gum can be increased using hyaluronic acid injections. If the gum has already "sagged", then a connective tissue transplant is required, which will cover the exposed roots and improve the cosmetic situation. Donor tissue is usually taken from the patient himself from the palatal area or from the tubercle area in the upper jaw, which is located behind the last tooth. A tiny, thin flap of tissue is taken, which requires the most delicate handling. The transplant is performed under high magnification with the thinnest needles. This is jewelry work.

Is it possible that the recession zone is quite large and the patient does not have enough of his own tissue for transplantation?
As practice shows, donor zones are completely restored in a few months. There were cases when we took a flap from one area 3-4 times, and the tissues were completely regenerated. Today, this is the most effective method that dentists have at their disposal for gum restoration.


You are one of the leading specialists in the field of gum tissue transplantation, and in order to learn your method, specialists not only from all over Russia and the CIS countries, but also from abroad came to your seminars. What is the reason for such interest in your method?
The fact is that plastic periodontology is a very young science, which emerged only 20 years ago. In the early 2000s, no one knew how to work with connective tissue transplants. There were some reports in the world professional press that it was possible to cover exposed roots with donor tissue from another part of the gum, but this method had not yet been developed and described. I really was the first to perform such a transplant, and I did it successfully. And now I can say that in all the years of practice I have not had a single complication. Well, since at that time no one had performed such a transplant, not just individual doctors, but the entire medical community needed training.

As you have already said, a patient with gum recession is primarily concerned with the aesthetic side of the issue, and plastic surgery solves this problem immediately. And what is the long-term effect of this operation on dental health?
Gum plastic surgery has a very powerful therapeutic, that is, healing component. This operation not only covers the root, but also prolongs the life of the teeth. This is proven by the research base that I have collected over many years of practice. Scientific data absolutely clearly indicate that connective tissue transplantation gives not only aesthetic results, but also leads to the restoration of the gum, and in some cases to the restoration of bone tissue.

Is it true that gum plastic surgery is almost always necessary when installing implants?
In my experience, such a need arises in 80% of cases. This is due to the fact that tooth extraction is often traumatic and, when applying for an implant, the patient already has problems with the gum. And they need to be solved. In order for the implant to serve for many years, it must be installed in healthy, adequate gums. Unfortunately, not all doctors understand this.

And what if one-stage implantation is performed, immediately after tooth extraction?
Less often, but in some cases, gum plastic surgery is necessary. After all, the tooth we are extracting was problematic, and these problems lasted for more than one day, which means that the gum has undergone changes. Our task is not just to install an implant, but also to replace the soft tissue defect. Only in this case can we talk about long-term success of treatment. I am happy to conduct follow-up examinations of patients whom I performed operations 5-10-20 years ago. They demonstrate stable results and excellent aesthetics.
 For me, as a doctor, this is the highest assessment of the work.