Gingival Graft: Autograft vs. Allograft?

I too prefer autografts to allografts because I feel that I get better results with the autografts. Sometimes the autograft is not an option, however, and then I will use allografts. They are safe and in the right hands, can be used quite successfully.As for the timing of the graft, I usually ask the orthodontist which direction that the tooth will be moving. If the tooth or teeth in question will be moved away from the existing bone, then the graft should be done prior to orthodontic therapy as the recession has a high likelihood of increasing. If the tooth or teeth in question will be moved into the existing bone, then you may want to start the orthodontic therapy and just monitor the area. If the situation starts to worsen, the grafting can be done at that time. There are many times when the tooth can be moved into the bone and the area improves without the need for the graft. Dr. Cheryl Goren Robins

Alloderm is an alternative, but studies have shown that donor tissue from the palate has a somewhat better long term durability, and develops a thicker graft. I have seen decent results with alloderm, but my preference is a palatal graft. There are 2 types of palatal harvests, a "free gingival graft" or a "connective tissue graft". Free gingival grafts can be more uncomfortable, while connective tissue grafts do not have too much discomfort. But either one can be well controlled with medication and the possible use of a post operative stent. Hope this helps. David E. Azar, DDS, FICOI, MgIDE