The Pinhole Surgical Technique
Enter the Pinhole Surgical Technique (PST), a minimally invasive treatment option to reverse gingival recession without grafting or sutures. What is PST (also referred to as the Lunchtime Gum Lift or Pinhole Gum Rejuvenation)? It is a novel procedure that combines techniques from traditional periodontal surgical procedures, such as coronally positioned flaps and guided bone regeneration, to reverse gingival recession. A coronally positioned flap (CPF) is a technique that requires creating an incision in the sulcus and across the papillae of affected teeth, elevating a flap (either full or split thickness), pulling the flap coronally, and suturing it into place. These techniques are often combined with autogenous grafts, allografts (cadaver), or xenografts (animal).
Like conventional grafting, there are limitations to the success of PST for reversing gingival recession. For example, root coverage is less predictable in areas of advanced bone loss due to a lack of bone support for the newly positioned tissue. Additionally, the patient must be free of inflammation and active periodontal disease at the time of surgery, compliant with postoperative instructions, and cease any traumatic activities that may have contributed to the recession, such as aggressive brushing. It is also recommended that the patient wear an appliance to protect from bruxism-induced occlusal trauma when indicated.