The soft tissues in the mouth-jaw region (gingiva, alveolar mucosa, vestibule, cheek and lip mucosa) are not only necessary for an aesthetic smile; periodontal health, phonetics, swallowing and chewing stability It is also of critical importance for the soft tissue surgeries at Valinor Dental Clinic; microsurgical principles, fine instruments worked under high magnification, laser technologies, bioactive healing supplements (PRF) And digital pre-planning It is implemented with. Our goal is; respectful of biology, painless and fast healing, aesthetic-function balance results that last for many years.
1) Gingivectomy (Clinical Crown Lengthening – Soft Tissue)
Definition: It is the extension of clinical tooth length and/or reduction of periodontal pocket depth by surgically removing excess gingival tissue.
Indications:
- “Gummy smile” (excessive gingival display at the smile line)
- Drug-induced gingival hyperplasia (some cardiac/epilepsy medications, etc.)
- Need to create restorative/prosthetic space (margin placement)
- Selected cases in periodontal pocket treatment
Planning – Biological breadth: With the current concept supracrestal tissue attachment approximately ~2 mm (epithelial + connective tissue). Gingivectomy should not be approached too closely to the bone level; if necessary osseous recontouring (bone correction) should be planned in the same session. Clinical-radiographic measurements, periodontal probing, and smile analysis are performed together.
Surgical steps:
- Local anesthesia → marking of reference lines → inwardly beveled incisions
- Removal of excess tissue and root surfaces complete smoothing
- If necessary laser/electrocautery hemostasis with
- Minimal suture with 6-0/7-0 PTFE or silk (in most cases, sutures may not be necessary)
Recovery & care: Epithelialization in 7–10 days; margin stabilization in 4–6 weeks. Chlorhexidine mouthwashes, avoidance of traumatic brushing, and a soft diet are recommended.
Complications: Excessive resection (gingival recession), margin relapse, tenderness.
Valinor difference: With digital smile photo-analysis 3D mock-up based surgical guide; laser-assisted bleeding-free procedure and PRF Accelerating healing with.
2) Gingivoplasty (Gingival Contour Shaping)
Definition: Gingival margin and papilla contours symmetrical and natural is a reshaping of a line.
Indications:
- Asymmetric zenith levels
- Disruption of marginal harmony in smile design
- Aesthetic finishing after gingivectomy/periodontal treatment
Technical: With microblades, laser or electrocautery microcorrection; the papilla apex is moved to a position compatible with the contact point.
Maintenance & results: Soft tissue closure within 1 week; stable aesthetic contour within 4–8 weeks.
Valinor difference: With smile line software teeth–lips–gum planning the trio together; when necessary emergence profile with temporary restorations shaping.
3) Mucosal Biopsies (Diagnostic Soft Tissue Surgery)
Definition: Suspicious lesions incisional (piece) or excisional (complete) is removed and sent for histopathological examination.
Indications: Leukoplakia, erythroplakia, pigmentations, non-healing ulcers, papilloma/fibroma, trauma-induced masses.
Technical:
- Marking → atraumatic excision; tension-free closure with wing-shaped incisions
- Laser excision possible; possibility of thermal artifact is adjusted according to histology
- Appropriate labeling of the sample with formalin and sending it to pathology
Follow-up: Removal of edge irritations, stitch removal in 7–14 days.
Valinor difference: Standard pathology reporting and digital archive; when necessary oncology–dermatology consultation and long-term screening.
4) Periodontal Plastic Surgeries (Muco-gingival Surgery)
Aim: Root coverage, keratinized tissue acquisition, papilla reconstruction and biotype thickening to increase both aesthetics and periodontal stability.
4.1 Root Covering Procedures
- Coronally advanced flap (CAF): The gold standard in single/multiple recessions. If necessary connective tissue graft combined with.
- Laterally displaced flap: In single tooth recessions with sufficient lateral tissue.
- Tunnel technique: Placement of connective tissue by tunneling without dividing the papilla—papilla integrity and preserves aesthetics.
- VISTA approach (submucosal advancement): Managing multiple tooth recessions with a single incision using superficial access.
Planning parameters: Recession depth, keratinized tissue width, buccal bone thickness, frenulum traction, patient's biotype (thick–thin).
Results: Uygun olguda %90+ tek diş kök örtümü; “creeping attachment” fenomeni ile 6–12 ayda ek kazanım.
4.2 Papilla Reconstruction
Problem: “Black triangle” appearance, phonetics and food impaction.
Solutions: Papilla-preserving flap designs, connective tissue/collagen matrix reinforcement, prosthetic optimization of the contact point level.
4.3 Keratinized Tissue Expansion – Peri-implant and Tooth Surroundings
Methods: Free gingival graft, apically positioned flap, collagen matrices.
Aim: ≥2 mm keratinized tape; better hygiene, lower risk of mucositis/peri-implantitis.
Valinor difference: Microsuture (6-0/7-0) under high magnification, atraumatic tunnel/plastic flap designs, healing acceleration with PRF; with the prosthetic team contact point and emergence harmony.
5) Free Gingival Graft (FGG)
Definition: It is the transplantation of a thin keratinized tissue flap taken from the hard palate to the area with keratinized tissue deficiency.
Indication: Keratinized band < 2 mm, reinforcement of the peri-implant mucosa, appropriate combination in vestibule shallowness.
Technical:
- Donor area template → 1–1.5 mm thick graft preparation
- Epithelial removal and bed preparation at the recipient site
- Suture + compression → graft clot stability
Care: For the donor area splint/special plate; avoidance of trauma in the recipient area.
Valinor difference: In the donor area pain-relieving closure and PRF membrane; a stabilization technique that reduces graft shrinkage.
6) Connective Tissue Graft (CTG)
Definition: Recession covering of connective tissue taken from the palate, papilla filling and biotype thickening to be used for the purpose of.
Indication: Fine biotype aesthetic zone, combined root coverage with CAF/tunnel, pink aesthetic improvement.
Technical:
- Connective tissue removal by single incision, double incision or “de-epithelialized FGG” methods
- Graft is placed under the tunnel/CAF with microsutures fixing
Advantage: Color/texture harmony maximum, shrinkage minimum.
Valinor difference: Graft thickness and architecture at mm level is planned; tissue maturity is monitored with photo-digital tracking.
7) Lip and Cheek Repairs (Preprosthetic & Aesthetic)
Scope: Correction of frenulum-band prints, cheek/lip mucosa defects, post-traumatic scars and bands, commissuroplasty mouth corner deformities that require.
Methods:
- Frenectomy / Frenuloplasty: Z-plasty or laser–microsurgery reduces traction-induced recession and prosthetic stress.
- Local flaps: Rotation/advancement V–Y flaps; functional and aesthetic repair of small to medium defects.
- Commissuroplasty: Correction of functional width and symmetry of the corner of the mouth.
Valinor difference: Protecting aesthetic lines (philtrum, vermilion border) micro suture and scar management; speech-smile-prosthesis balance is planned together.
8) Vestibuloplasty (Vestibule Deepening)
Definition: Increasing the vestibule depth between the gum and lip; traction forces It is done to reduce the risk of bleeding and facilitate hygiene around the prosthesis/implant.
Indication: Shallow vestibule, keratinized tissue insufficiency, removable prosthesis retention problem, peri-implant hygiene difficulty.
Technical:
- Mucosal repositioning: Apically positioned flap and periosteal fixation
- Combined vestibuloplasty with FGG: Both depth and keratinized band gain
- Classically defined techniques (e.g. Kazanjian/Clark principles) are adapted to the patient.
Care: Long-term shape maintenance with splint/prosthesis stent; tension-free tissue adaptation.
Valinor difference: Suture–splint coordination and a protocol focused on reducing relapse with PRF; second-stage fine contour corrections if necessary.
9) Laser-Assisted Surgeries (Soft Tissue & Photobiomodulation)
Scope: Gingivectomy/gingivoplasty, frenectomy, mucosal biopsy/excision, pigmentation (melanin) removal, adjuvant treatment of peri-implant mucositis, photobiomodulation in pain-edema control.
Advantage: Bleed-free vision, minimal postoperative pain/edema in most cases seamless closure, rapid recovery.
Protocols:
- Wavelength and power settings are carefully selected according to tissue type.
- To reduce thermal damage impulse mode and continuous irrigation
- Low-dose–multiple-session principle in photobiomodulation
Valinor difference: Laser is not just a “cutter”; biomodulator It is also used as a post-operative treatment. Post-operative comfort and recovery speed increase significantly.
Preoperative–Postoperative Standards (Valinor Protocol)
- Preparation: Medical history, anticoagulant/antiresorptive evaluation, periodontal indices, high-resolution photo–video recording.
- Anesthesia & sedation: Local anesthesia; conscious sedation may be preferred in anxious patients.
- Sterility: Disposable barriers, atraumatic vacuum–irrigation.
- Sutures: 6-0/7-0 PTFE, monofilament or silk; tension-free, papilla-protective nodes.
- Medicines: Analgesic, short-term antiseptic gargles as needed; broad-spectrum antibiotics only if indicated.
- Care: 24–48 hours of ice application (when necessary), a soft diet, smoking and alcohol restriction, a “skip” technique in brushing, and interdental hygiene education.
- Control: Suture control at 7–10 days; tissue maturity assessment at 4–6 weeks and 3 months. Long-term periodic follow-up at 6–12 months.
Possible Complications and Management
- Bleeding/hematoma: Compression, local hemostatic; rarely revision.
- Graft loss/necrosis: Stabilization, infection control; second-stage correction.
- Seam burst/dehiscence: Temporary protective plate, resuture.
- Tenderness/pain: Desensitizing agents, temporary composite dressing.
- Aesthetic failure/relapse: Second stage fine contour–papilla corrections.
Valinor Dental Clinic Difference – Fine Craftsmanship of Soft Tissue Surgery
- Microsurgical approach: Minimizing trauma with high magnification, fine instrument sets, and microsutures.
- Digital aesthetic integration: Gum contour, smile line and tooth form planned together with temporary restorations if necessary emerald profile engineering.
- Biotype management: In thin biotype connective tissue thickening and long-term stability with keratinized tissue recovery.
- Laser + PRF synergy: Non-bleeding area, low pain-edema, rapid recovery.
- Peri-implant focus: The thickness and keratinization of the peri-implant mucosa are systematically strengthened; the risk of peri-implantitis is reduced.
- Classic elegance: The result is not just “surgically correct”; natural, elegant and symmetrical visible.
Soft tissue surgery is a small operation room rather than a large operating room. watchmaker's meticulously carried out micro-aesthetics is a discipline. At Valinor Dental Clinic, every incision, every suture, every millimeter; long-lasting health, comfort and an elegant smile is planned for.
The goal here is not to cut tissue, with respect for the texture is to rebuild the smile
Soft Tissue Surgeries Frequently Asked Questions (FAQ)
1. What is soft tissue surgery?
It is the general name of surgical procedures involving the gums, tongue, lips, cheeks and mucosa in the mouth.
2. In what cases is soft tissue surgery performed?
Gum growth, recession, aesthetic disorders, mucosal masses, frenulum anomalies and prosthesis compatibility problems.
3. What is gingivectomy?
It is the process of surgically removing the overgrown gum.
4. What is gingivoplasty?
It is the shaping of the gums to make them aesthetic and functional.
5. What is the difference between gingivectomy and gingivoplasty?
In gingivectomy, excess tissue is removed, while in gingivoplasty, existing tissue is reshaped.
6. Is gingivectomy painful?
No. It is performed under local anesthesia and is painless.
7. What is the recovery time after gingivectomy?
It usually heals within 1–2 weeks.
8. How is the smile aesthetics after gingivoplasty?
Teeth lengthen, the tooth-gum ratio improves, and a more aesthetic smile is achieved.
9. What are the causes of gum enlargement?
Medication use (e.g., epilepsy medications), hormonal changes, plaque buildup, and genetic factors.
10. Can laser be used to treat gum hyperplasia?
Yes. Laser provides faster healing and less bleeding.
11. What is gum recession?
The gum retracts downwards from the root surface, exposing the root.
12. What causes gum recession?
Improper brushing, trauma, genetic predisposition, gum disease and orthodontic treatments.
13. Can receding gums be treated?
Yes. It can be closed with connective tissue grafts or other surgical methods.
14. What is a connective tissue graft?
It is the transplantation of tissue taken from the palate area to the area where the gums have receded.
15. Is a connective tissue graft painful?
It is performed under local anesthesia, and the patient does not feel pain during the procedure.
16. What is the recovery time after connective tissue graft?
Recovery occurs in approximately 2–3 weeks.
17. What are the aesthetic results of a connective tissue graft?
The receding gums are closed, the tooth roots are not visible and a more youthful smile is achieved.
18. What is a free gingival graft?
It is the transplantation of thin gum tissue taken from the palate or another area.
19. In which cases is free gingival graft applied?
If the gum thickness is insufficient or tissue augmentation is required for denture compatibility.
20. What is the advantage of a free gingival graft?
It increases gum thickness and reduces the risk of future recession.
21. What is frenectomy?
It is the surgical cutting/correction of the lip or tongue tie.
22. How is tongue tie (ankyloglossia) treated?
With frenectomy, the tongue tie is cut and the tongue is allowed to move freely.
23. Can frenectomy be performed for lip tie aesthetics?
Yes, the upper lip tie can be removed for aesthetic and orthodontic reasons.
24. Can frenectomy be performed with laser?
Yes. Less bleeding means faster healing.
25. Does speech improve after frenectomy?
When the tongue tie is removed, speech problems such as lisping can be corrected.
26. Will breastfeeding problems be solved after frenectomy?
Yes, sucking becomes more comfortable for babies.
27. Is frenectomy safe in children?
Yes, it is a simple and safe process.
28. Will there be pain after frenectomy?
There may be very mild pain, but it passes in a short time.
29. Does lip tie cause gaps in teeth?
Yes, the upper lip tie can create a wide gap (diastema).
30. Will the gap between teeth close when the lip tie is removed?
Yes, it can be closed with orthodontic treatment.
31. What is vestibuloplasty?
It is the process of deepening the space (vestibule) between the gum and cheek.
32. Why is vestibuloplasty performed?
To improve prosthetic fit, prepare the area for gingival grafting and reduce the risk of recession.
33. What is the recovery time after vestibuloplasty?
Usually 2–3 weeks.
34. Does vestibuloplasty make prosthesis use easier?
Yes, it increases the stability of removable dentures.
35. Does vestibuloplasty increase implant success?
Yes, it provides tissue compatibility and ease of cleaning.
36. Is vestibuloplasty painful?
No, it is performed under local anesthesia.
37. What is laser-assisted surgery?
These are minimally invasive soft tissue surgeries performed using laser devices.
38. What are the advantages of laser surgery?
Less bleeding, faster healing, less pain.
39. Can laser gum shaping be done?
Yes, it is frequently used for smile aesthetics.
40. Can aphthous ulcers be treated with laser?
Yes, it reduces pain and speeds up healing.
41. What is an oral mucosal biopsy?
It is the process of taking samples from suspicious lesions in the mouth for diagnosis.
42. Is a biopsy painful?
No, it is done with local anesthesia.
43. Are stitches required after the biopsy?
Yes, it is usually closed with small stitches.
44. What is the recovery time after a biopsy?
1–2 weeks.
45. Will speech be affected after the biopsy?
No, it does not affect small lesions.
46. Why is soft tissue biopsy important?
To understand whether the lesion is benign or malignant.
47. Can I eat after an oral biopsy?
Yes, but soft foods should be preferred on the first day.
48. Is oral biopsy risky?
No, it is a simple and safe process.
49. Will there be pain after a soft tissue biopsy?
There may be mild pain, but it passes in a short time.
50. How long does it take to get the biopsy results?
Usually within 1–2 weeks.
51. Is pain normal after soft tissue surgery?
Yes, mild pain may occur and is usually controlled with simple painkillers.
52. Will there be swelling after soft tissue surgery?
Yes, it can be seen especially in graft operations and it will subside within a few days.
53. Are stitches removed after soft tissue surgery?
Dissolvable stitches are usually used, but in some cases they can be removed after 7–10 days.
54. Is bleeding normal after soft tissue surgery?
There may be slight leakage in the first 24 hours; severe bleeding should be reported to the physician.
55. How should the post-operative diet be?
Soft and warm foods should be preferred on the first day.
56. Is smoking harmful after surgery?
Yes, it seriously impairs wound healing and is definitely not recommended.
57. Can I consume alcohol after soft tissue surgery?
No, alcohol delays healing and can interact with medications.
58. Are antibiotics required after soft tissue surgery?
In some cases, yes, it depends on the doctor's recommendation.
59. How should oral hygiene be maintained?
A soft brush, mouthwash and care products recommended by the physician should be used.
60. Can I do sports after soft tissue surgery?
Heavy exercise should be avoided for the first few days.
61. Is soft tissue surgery safe in children?
Yes, it can be performed safely with appropriate anesthesia.
62. Can soft tissue surgery be performed on the elderly?
Yes, there is no age limit if the general health condition is suitable.
63. Is soft tissue surgery performed under local or general anesthesia?
Local anesthesia is usually sufficient; general anesthesia may be used for very large procedures.
64. Will there be bad breath after the operation?
It may be temporary, but it will quickly resolve with cleaning.
65. Is recovery faster in laser procedures?
Yes, the laser sterilizes the tissues and reduces bleeding.
66. Is laser surgery safe?
Yes, it is safe thanks to the controlled use of energy.
67. Can soft tissue surgery be performed for aesthetic purposes?
Yes, it is frequently used for smile aesthetics and gum shaping.
68. Can a gummy smile be treated?
Yes, with gingivectomy, botox or surgical methods.
69. How to correct gum asymmetry?
With gingivoplasty or laser gum shaping.
70. When can I return to work after soft tissue surgery?
Usually the next day, but for major procedures it is beneficial to rest for 2–3 days.
71. Are soft tissue grafts necessary in implant treatment?
Yes, it is used to create healthy gums around the implant.
72. Does soft tissue surgery prolong implant life?
Yes, healthy gums increase the success of implants.
73. Can a soft tissue graft fail?
Rarely, it may fail due to insufficient blood supply or infection.
74. What to do if the graft does not take?
Rescheduling can be done after recovery.
75. Is it difficult to obtain tissue from the palate?
No, it is a simple procedure with local anesthesia.
76. How long does it take for the palate area to heal?
Usually within 1–2 weeks.
77. Is there any palate sensitivity after a connective tissue graft?
Yes, in the first days, but it quickly improves.
78. How long do graft operations take?
Usually between 30–60 minutes.
79. Will eating become difficult after the graft operation?
It may be in the first days, a soft diet is recommended.
80. Will stitches be removed after the graft?
Yes, usually after 7–10 days.
81. How to repair lip tears?
It is closed aesthetically with surgical stitches.
82. How are cheek injuries treated?
Small wounds are sutured, and large defects can be repaired with tissue transplantation.
83. Do lip and cheek reconstructions provide aesthetic results?
Yes, the scars are hidden in natural lines.
84. Is there any loss of sensation after lip surgery?
Temporary numbness may occur but usually resolves.
85. Will speech be impaired after lip surgery?
No, function is preserved.
86. Can lip contour be preserved after lip reconstruction?
Yes, symmetry is achieved with modern techniques.
87. Will there be swelling after cheek surgery?
Yes, it will subside within 1–2 weeks.
88. Can laser be used for lip repairs?
Yes, it provides rapid and bleeding-free healing for small lesions.
89. Is lip biopsy safe?
Yes, it is a simple and safe process.
90. Will there be any scars after a lip biopsy?
No, it usually heals invisibly.
91. How long does laser aphtha treatment take?
Usually 5–10 minutes.
92. Will aphthae recur when removed with laser?
Yes, if the cause of the canker sore is not resolved, it may recur.
93. Can laser treatment be used for herpes?
Yes, it speeds up healing.
94. Is dry mouth possible after soft tissue surgery?
It may appear temporarily.
95. Is the sense of taste affected after soft tissue surgery?
No, in rare cases, temporary tenderness may occur.
96. Is lip swelling normal after soft tissue surgery?
Yes, it will come down soon.
97. Are there any allergies after soft tissue surgery?
Very rarely, it may develop depending on the materials used.
98. Are antibiotics necessary after soft tissue surgery?
Not always, it depends on the physician's decision.
99. What about aesthetics after soft tissue surgery?
A more symmetrical, healthy and aesthetic mouth appearance is achieved.
100. Is soft tissue surgery beneficial in the long term?
Yes, it offers permanent solutions, both aesthetically and functionally.
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