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control until treated","Heavy smoking (relative; worsens graft success)","Uncontrolled diabetes or other uncontrolled systemic disease","Bleeding disorders or anticoagulation that cannot be safely managed","Recent head and neck radiotherapy (relative)","Bisphosphonate or antiresorptive therapy with jaw osteonecrosis risk (relative)","Pregnancy for elective procedure (relative)","Untreated traumatic brushing habits causing the recession"],"days_in_clinic":{"min":0,"max":0,"unit":"nights","qualifier":"Performed as an outpatient dental procedure without overnight stay."},"diagnostic_duration_minutes":null,"diagnostic_preparation":null,"diagnostic_referral_needed":null,"diagnostic_result_time_hours":null,"exercise_resume_weeks":{"min":1,"max":2,"unit":"weeks","qualifier":"Strenuous exercise avoided for about 1-2 weeks after surgery."},"final_result_months":{"min":3,"max":6,"unit":"months","qualifier":"Tissue maturation and final gingival contour/colour integration over roughly 3-6 months."},"fly_home_after_days":{"min":7,"max":14,"unit":"days","qualifier":"Usually after first wound check and suture removal; extent of grafting and palatal donor site healing move timing."},"follow_up_visits":[{"purpose":"wound_check","requirement":"routine","after":{"min":7,"max":14,"unit":"days","qualifier":"First postoperative check, often with suture removal depending on technique."}},{"purpose":"result_review","requirement":"routine","after":{"min":28,"max":60,"unit":"days","qualifier":"Healing and hygiene review."}},{"purpose":"assessment","requirement":"routine","after":{"min":90,"max":180,"unit":"days","qualifier":"Assessment of root coverage and tissue stability."}}],"indications":["Gingival recession with root exposure causing aesthetic concern","Dentin hypersensitivity from exposed roots unresponsive to conservative measures","Progressive recession threatening tooth support","Root coverage before restorative or orthodontic treatment","Thin gingival phenotype with inadequate attached tissue"],"main_risks":["Partial graft failure or incomplete root coverage","Palatal donor-site pain, bleeding or delayed healing","Postoperative swelling, bruising and infection","Recurrence of recession","Temporary or persistent tooth sensitivity","Scar-like or mismatched tissue colour/contour","Rarely, numbness"],"pain":"Procedure is painless under local anesthesia; mild to moderate discomfort for several days afterward, usually greater at palatal donor site, controlled with common analgesics.","preparation":["Periodontal evaluation and treatment of inflammation, with professional cleaning","Training in gentle brushing technique to remove traumatic habits","Review of medical history and medications with the dentist","Smoking cessation advised before and after surgery"],"recovery_timeline":[{"phase":"Days 0-7","description":"Initial healing with swelling and mild pain; palate donor site tender if graft harvested.","restrictions":["Soft cool diet","No brushing at the surgical site","Avoid pulling lip to inspect site","Chlorhexidine rinse as advised"]},{"phase":"Days 8-28","description":"Sutures usually removed by day 14; gradual return to gentle cleaning and normal diet.","restrictions":["Gentle brushing only with soft brush near site","Avoid hard or crunchy foods on the site"]},{"phase":"Months 1-6","description":"Tissue maturation and final aesthetic result.","restrictions":[]}],"rehabilitation_days":{"min":7,"max":14,"unit":"days","qualifier":"Ordinary functional recovery of eating and oral hygiene for a limited-site graft."},"result_longevity":"Often stable for years with good oral hygiene and non-traumatic brushing; recurrence possible without periodontal maintenance.","revision_rate_pct":{"min":5,"max":15,"unit":"percent","qualifier":"Repeat grafting of a treated site within about 2 years due to incomplete coverage or recurrence."},"scars":"No external scars; palatal donor site (if used) heals with a temporary wound, and grafted tissue may differ slightly in colour or texture.","sessions_or_stages":{"sessions":{"min":1,"max":1,"unit":"visits","qualifier":"One surgical appointment for a single site or adjacent teeth."},"stages":[{"code":"graft_surgery","label":"Recession coverage surgery (coronally advanced flap with connective tissue graft)","after":{"min":0,"max":0,"unit":"days","qualifier":"Performed at the initial session."}}],"qualifier":"Multiple areas may be staged separately; follow-up checks are not counted as treatment sessions."},"success":{"metric":"Mean root coverage of exposed root surface","value":85,"unit":"percent","horizon":"6-12 months","population":"Adults with Miller class I-II recession treated with coronally advanced flap plus connective tissue graft","evidence_status":"limited"},"techniques":[{"name":"Coronally advanced flap","suits_whom":"Single or multiple recessions with adequate keratinized tissue and thick phenotype, no donor site required.","recovery":"Less discomfort without palatal wound; healing about 1-2 weeks."},{"name":"Coronally advanced flap with connective tissue graft","suits_whom":"Recessions with thin tissue needing thickness and best root coverage predictability.","recovery":"Palatal donor discomfort for about 1-2 weeks."},{"name":"Tunnel technique","suits_whom":"Multiple adjacent recessions, often with a graft.","recovery":"Similar to graft-based procedures, about 1-2 weeks."}],"treatment_conditions":["outpatient"],"treatment_duration_hours":{"min":1,"max":2,"unit":"hours","qualifier":"For one to a few adjacent teeth in one surgical session."},"initial_assessment_documents":["Close-up photos of affected gums and teeth","Photos showing smile line and gum display","Panoramic dental X-ray (OPG)","Periapical X-rays of recession sites (if available)","Current medication list, including blood thinners"],"travel_trips":{"min":1,"max":1,"one_trip_possible":true,"qualifier":"Single-stage surgery; stay 7-14 days for suture removal and first wound check. Later reviews can be remote or local."},"clinic_checks":{"status":"ok","items":[{"id":"C1","text":"Ask where the graft tissue will be taken from","scope":"procedure","source":{"url":"https://www.ada.org/resources/ada-library/oral-health-topics/periodontitis/","host":"ada.org","quote":"During this procedure, tissue is taken from the palate or another donor source to cover exposed roots.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C2","text":"Ask what the gum graft is intended to achieve for your gums","scope":"procedure","source":{"url":"https://www.ada.org/resources/ada-library/oral-health-topics/periodontitis/","host":"ada.org","quote":"Gum graft surgery is intended to prevent further gingival (gum) recession and bone loss and to reduce sensitivity.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C3","text":"Check that regular maintenance visits are included in the plan; without them, recurrence and tooth loss are more 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case","scope":"treatment_type","source":{"url":"https://www.ada.org/resources/ada-library/oral-health-topics/periodontitis/","host":"ada.org","quote":"Treatment of periodontitis can be non-surgical or surgical.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}}],"checked_at":"2026-11-13","next_check_at":"2027-11-13","version":1},"red_flags":{"status":"ok","items":[{"id":"F1","text":"The offer presents the graft as a sure fix rather than an intended benefit","scope":"procedure","source":{"url":"https://www.ada.org/resources/ada-library/oral-health-topics/periodontitis/","host":"ada.org","quote":"Gum graft surgery is intended to prevent further gingival (gum) recession and bone loss and to reduce sensitivity.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"F2","text":"The same fixed treatment is offered to everyone without assessing your site or general 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