A Minimally Invasive Method to Correct Gum Recession:The Pinhole® Surgical Technique (PST™)

We are frequently are asked about The Pinhole® Surgical Technique (PST™) to correct gum recession.  The purpose of this blog will clarify some of the hype around this surgical technique. The information below describing the technique was taken directly from Dr. Chao’s website.

What is The Pinhole Surgical Technique (PST™)

The Pinhole® Surgical Technique (PST), also known as Pinhole® Gum Rejuvenation, is a scalpel-free, suture-free procedure for correcting gum recession. It was developed and patented by Dr. John Chao, a general dentist from California. According to Dr. Chao, a small hole is made by a needle into the gums, the surgeon uses specially designed instruments to gently loosen the gum tissue, bioabsorbable  collagen membranes are placed under the loose tissue  and the gums are positioned over the receded part of the tooth. Since there is no cutting or stitching, patients can expect minimal post-operative symptoms (pain, swelling and bleeding). Most patients also are pleasantly surprised by the instant cosmetic improvement. 

What are the benefits of Pinhole® Surgical Technique (PST™)?

The benefits of the Chao Pinhole® Surgical Technique are as follows:

  • Less discomfort for the patient after treatment
  • Faster recovery for the patient than traditional grafting
  • No need for uncomfortable sutures
  • No need for scalpels or invasive surgical tools
  • No need to take donor tissue from the patient’s palate
  • Excellent, natural-looking, long-lasting results
After: Same patient: Recession corrected on upper left canine tooth#11 using a modification of the Pinhole Surgical Technique

Dr. Tassos Sfondouris Commentary

The Chao Pinhole® Surgical Technique is a valid technique that can be used to improve gum recession. However, it is one of many plastic surgical procedures used to correct gum recession.

A common question that  arises is,  “Are there any long-term data that the critically analyze the long term stability of the improved gum recession using this technique? The answer is No. Since The Pinhole® Surgical Technique (PST™) is a patented and protected technique, it would be very difficult or impossible to design a randomized, multi-centered, split-mouth study to test its efficacy and long term results compared to other plastic surgical techniques.

One scientific 6 month randomized clinical study compared the clinical outcomes following treatment of localized gum recessions by a coronally (advancing the gums over the receded roots) positioned flap procedure alone (control), or in combination with a with a bioabsorbable membrane. This study found no statistical and clinical difference in combining this technique with the placement of a bioabsorbable membrane and this technique does not seem to improve the results following surgical treatment of such defects.

Another key question patients’ ask is, “If there are no cut, no blades and no sutures, how is it possible to keep the gums to cover the exposed root surfaces?” All practicing surgeons are keenly aware of the surgical and anatomical considerations when performing a dental surgery.  Specifically, to reposition the gum tissues to new higher position on a tooth to cover an exposed root surface, an incision must to made to release the periosteoum. The periosteoum is an outer membrane of band of irregular connective tissues that cover the bone. These fibers must be released by an incision in order for the tissues to be raised Passively to a new position. If this is not completed, the gum tissue will inevitably return to its previous lowered position. The end result is that the gum recession will not be corrected.

The  Pinhole® Surgical Technique (PST™) can be used to treat gum recession and the surgeon must release the periosteoum if the desired result is to advance  the tissues to a newer position to cover the gum recession defects. By performing this or any other soft tissue plastic surgical procedure to treat gum recession, there will be discomfort and swelling. However, this can be managed by anti-inflammatory and pain medications to significantly lessen the discomfort.


Dr. Sfondouris uses an array of cosmetic plastic surgical techniques to treat gum recession. Surgical treatments to correct gum recession should be treated by Periodontists, since they are the doctors who understand the biology as well have the surgical training to perform these types of advanced surgical procedures. Techniques are not meant to replace the critical thought process of obtaining the correct the diagnosis, etiology and treatment for the gum recession. After a critical and detailed analysis, Dr. Sfondouris will use the best available scientific evidence as well as his creativity and innovation to attain optimal treatment results. He understands that patient’s are people with unique challenges and desires. There is not a one shoe or one technique fit approach to treating patients

Please, feel free to contact our practice to learn more about how we can help you treat your gum recession!

Information about the Author: Dr. Tassos Sfondouris is a board certified periodontist and a former clinical assistant professor at the University of Maryland, School of Dentistry. He is passionate about periodontal and restorative therapies that promote the health, comfort, and function of teeth. He welcomes your comments and suggestions and encourages you to like him on Facebook or follow him on Twitter to get the latest unbiased information on dental health topics.


1. Chao JC. A novel approach to root coverage: the pinhole surgical technique.Int J Periodontics Restorative Dent. 2012 Oct;32(5):521-31.

2. Amarante ES et.al. Coronally positioned flap procedures with or without a bioabsorbable membrane in the treatment of human gingival recession. J Peiodontol 2000 Jun;71(6):989-98.