Pinhole surgery, also called the Chao pinhole surgical technique (PST), is a minimally invasive surgery for treating receding gums. It restores soft-tissue coverage to exposed roots without the need for the scalpels or sutures used in gum grafting.Â
Your dentist or periodontist creates a small hole in the gum, then inserts a special tool to free the gingiva from the underlying bone and tooth. Then they reposition the gum tissue over the exposed root, lowering the gumline.Â
The pinhole surgical technique is a relatively new procedure, developed by Dr. John Chao, an Alhambra, California dentist and research professor of Periodontics at the University of Buffalo, SUNY. It's a less invasive treatment option than the current standard of care for gum recession: traditional gum grafting, which uses donor tissue taken from your palate or a cadaver.Â
Candidates for PST are selected on a case-by-case basis. As Dr. Elly Tehrani, a periodontist in Toronto, explains in a RealSelf Q&A, “It is not suitable for all patients. You need to have some thick gum tissue available.” Additionally, the pinhole technique isn’t recommended for people with advanced bone loss.
Pros
Cons
A pinhole surgical procedure usually takes one to two hours and requires only local anesthesia.
Once you're numb, the dentist uses a specialized needle to make pinhole-size incisions (roughly two to three millimeters) in the gums. They insert a thin instrument to loosen the soft tissue and reposition the gumline over areas of exposed root, inserting resorbable collagen strips beneath the tissue grafts to improve healing.Â
Postoperative pain is significantly less than what you'd have after traditional gum grafting surgery, but you may need over-the-counter pain medication for a few days. Icing the area can also ease discomfort.
You'll have about a week of recovery time, with some swelling and tenderness. Avoid hard, sharp, and stringy foods and avoid brushing, flossing, and touching the area until your dentist gives you the green light to resume routine oral care.Â
According to RealSelf members’ before and after pictures, you may see optimal results around six weeks post-treatment.Â
Pinhole gum surgery results are permanent. However, aging, aggressive brushing, and teeth grinding can continue to erode gums and teeth over time.
Updated August 16, 2023