Pinhole Surgical Technique – right for whom?

Gum lifting or gum reconstruction with the patented pinhole surgical technique (PST) by Dr. John Chao (Los Angeles, USA) can, in principle, be used for anyone who suffers from gum loss. However, a sufficient amount of healthy bone must exist before a gum lifting using PST can be performed. The oral cavity must also be free of inflammation. Gum loss can arise from:

  • periodontitis
  • teeth grinding/compression
  • orthodontic treatments
  • incorrect teeth brushing
  • smoking
  • poor dental hygiene
  • Abrasion from tongue or cheek piercings
  • hereditary factors
  • hormonal changes

Before considering a gum lift, you should:

  • Consult with the dental team at the Bärenklau dental practice
  • Determine if there are any inflammatory processes that need to be treated beforehand
  • In the examination, determine if one of the above causes exists and if it can or must be overcome
  • Have your teeth professionally cleaned by the team at the Bärenklau practice
  • Be aware that a gum lift with the patented pinhole surgery by Dr. John Chao (Los Angeles) is a highly individualized treatment that requires great dexterity; it is offered in Munich by Christian Bärenklau as an authorized surgeon and is associated with costs that are not covered by insurance.

The pinhole surgical technique: A solid foundation is required

For gum lifting using pinhole surgery to be successful, a sufficient amount of solid jaw bone (alveolar bone) for PST is required. This means that for anyone who has visible gum loss, the sooner action is taken, the better. Another prerequisite is first to stop and heal any acute or chronic inflammation in the oral cavity. Periodontitis needs to be cured beforehand. It is evident that there are several requirements before a gum lift can achieve the desired goal of a stable gingiva, which serves a protective function and enables an aesthetically attractive smile.

Recession classes according to Dr. Miller

For gum lift specialist Christian Bärenklau, it is particularly important to determine the extent to which the gums have already receded before commencing pinhole surgery. How promising is gum restoration with PST? Useful in answering this question is a classification method, the so-called Miller classes, developed by U.S. dentist, Dr. Preston D. Miller in 1985. Generally speaking, class 1 equals light to moderate gum loss. The tooth neck can be completely covered and the gums can thicken with a gum lift using pinhole surgery. Here, the prognosis is highly promising. With Miller class 2 gum loss, even though the recession is somewhat advanced, satisfactory results from a gum lift with the pinhole surgery technique is possible since the bone is hardly affected. Thicker gums are desirable in this case as well in order to stop the gums from receding further. The Miller class 3 is characterized by a more pronounced loss of tissue (“partial loss of the interdental papillae”) and a partial loss of the underlying bone. The root surface or tooth neck can still be covered, however only up to the existing gum/bone line. The lost interdental papillae cannot be restored. Nonetheless, a gum lift by pinhole surgery with a favorable prognosis is still possible. With the Miller class 4, the gum and papillae surrounding the tooth are irretrievably lost, and the alveolar bone underneath is also damaged. A sober estimation of what is feasible must be made. The situation can be stabilized through reinforcement or consolidation. However, complete restoration is impossible.

How much does a PST-gum lift cost?

The cost of gum lifting by pinhole surgery is the most frequently asked question, both on the phone and in our practice. It needs to be stated in advance that the precise cost cannot be predicted. Unfortunately, there is no “kit” for successful gum lifting using the pinhole surgical technique with precisely enumerated costs. Quite the opposite is true. Situations arise in which a gum lift by pinhole surgery on three teeth can be more expensive than with five or six teeth. There is no rule of thumb or formula for making an estimate. A treatment and cost schedule can be prepared after a thorough, detailed and non-binding consultation with dentist Christian Bärenklau.

The pinhole surgical technique — Case-by-case charges

Why? Gum lifting by pinhole surgery is a highly individualized treatment. It is true than the pinhole surgical technique by Dr. John Chao is a patented, standardized and highly effective treatment method. Nonetheless, a wide variety of factors are involved in a gum lift. The surgical approach depends on how far the gum has receded, how accessible the damaged parts of the gum are, how much material must be used for the gum lift, how many healthy adjacent teeth there are, and whether there are there any sources of inflammation that must be treated beforehand, etc. The team at the Bärenklau practice appreciates that you would like to know the precise cost of a gum lift beforehand, especially since it is not reimbursed by insurance in Germany and the patient must pay for it.