What is the difference is between a free gingival graft and a connective tissue graft?

This is a guest post written by my good friend and colleague Dr Philip Pack, an excellent periodontist practicing in New York City. I have known him for many years and often pick his brain on all matters of a periodontal nature.

Patients are really not sure what the difference is between a free gingival graft and a connective tissue graft. Patients know that both grafts are taken from the palate but are otherwise confused.

The free gingival graft is an excellent choice where the goal is to increase the amount of hard gum tissue (keratinized tissue) around a tooth. It is best used in non-esthetic areas where root coverage is not the objective. Increasing the amount of keratinized tissue will decrease the likelihood of further recession.

The connective tissue graft is the best choice where there is an esthetic problem or hot and cold sensitivity. It is the procedure of choice for covering exposed roots and obtaining a good tissue blend. A good tissue blend means that it is difficult to distinguish the graft from the adjacent tissue.

The tissue harvested from the palate for a free gingival graft is from the surface and is rectangular in shape. The connective tissue graft is also rectangular but is harvested from underneath the surface tissue. The incision for the connective tissue graft is a narrow straight line and usually heals more quickly because it is smaller.

Both procedures have been performed for many years and have stood the test of time.