Chao Pinhole® Technique

What Is the Chao Pinhole® Technique?

Gum recession treated without cutting or grafting

The Chao Pinhole® Surgical Technique (PST) is a patented, minimally invasive procedure for treating gum recession. Instead of cutting a graft from the roof of the mouth and suturing it into place — the traditional approach — the Pinhole Technique uses a small needle to create a tiny entry point in the existing gum tissue. Specially designed instruments are then used through that pinhole to loosen and gently reposition the gum over the exposed root surface.

Collagen strips are placed through the pinhole to stabilize the repositioned tissue and encourage new attachment. The pinhole itself is so small it closes on its own — no sutures, no cutting, no palatal donor site. Most patients see an immediate visual improvement the same day of treatment.

At Wellington Periodontal Associates, the Pinhole Technique is offered as an alternative to traditional connective tissue grafts for appropriate cases of recession. Our specialists will evaluate your tissue type, recession pattern, and overall periodontal status to determine whether Pinhole or conventional grafting is the better choice for your specific situation.

What It Treats

Gum recession exposing root surfaces
Cold sensitivity from exposed roots
Multiple teeth treated in one visit
Cosmetically uneven gumlines

Procedure Details

Treatment time: 1–2 hours
Multiple teeth: same session
Return to work: typically next day
No palate donor site needed

Same-Day Results

Unlike traditional gum grafting, where results develop over weeks of healing, patients treated with the Pinhole Technique see their gumline repositioned immediately — the improvement is visible before you leave the chair.

How It Works

The Pinhole Technique, step by step

The entire procedure takes place through a tiny pinhole entry point — no incisions, no sutures, no second surgical site.

Evaluation & Planning

We assess recession depth, tissue thickness, and root exposure at every affected site. We confirm the Pinhole Technique is appropriate for your tissue type and recession pattern.

Pinhole Entry

Under local anesthesia, a needle creates a tiny opening in the gum above the area of recession. No incision is made — the pinhole is the only access point for the entire procedure.

Tissue Repositioning

Specially designed instruments are passed through the pinhole to gently loosen and slide the existing gum tissue downward over the exposed root surface — covering recession immediately.

Collagen Stabilization

Collagen strips are threaded through the pinhole to hold the repositioned tissue in place and stimulate new attachment. The pinhole closes on its own within 24 hours.

Why Choose Pinhole

How Pinhole compares to traditional gum grafting

No cutting or sutures

Traditional grafting requires cutting a tissue sample from the roof of the mouth. Pinhole uses only a needle entry point — no scalpel, no stitches, no palate wound to heal from.

Significantly less discomfort

Without a palate harvest site, post-operative pain is dramatically reduced. Most patients describe the recovery as far more comfortable than they expected, often needing only mild over-the-counter pain relief.

Immediate visible results

The gumline is repositioned during the procedure itself — you see the improvement the same day. With traditional grafts, you wait weeks for swelling to resolve before seeing the final outcome.

Multiple teeth in one visit

Traditional grafting is typically limited to a few teeth per session. With Pinhole, multiple areas of recession across the entire mouth can be treated in a single appointment.

Fast return to normal activity

Most patients return to work the next day. Without a palate wound, the only restriction is a soft diet for a week or two to protect the treated gum tissue during early healing.

Covers exposed roots, reduces sensitivity

By repositioning gum tissue over the root surface, Pinhole directly reduces cold and tactile sensitivity — one of the most common and frustrating symptoms of gum recession.

Am I a Candidate?

Pinhole works best when these conditions are present

Good candidates for the Chao Pinhole® Technique typically have:

Visible gum recession on one or more teeth, with exposed root surfaces

Adequate existing gum tissue volume to allow repositioning (not severely thin)

Cold sensitivity, tooth appearance concerns, or fear of further recession

Controlled gum disease — active infection must be treated before any grafting

Preference for a less invasive approach with faster recovery

When traditional grafting may be better

For very thin tissue biotypes or severe recession where tissue volume is insufficient to reposition, a traditional connective tissue graft may achieve a more predictable result. Our doctors will be straightforward about which approach gives you the best long-term outcome — not the easiest one to perform.

What to Expect

Before, during, and after Pinhole treatment

Before

Recession mapping and candidacy confirmation

We measure recession depth at every site and assess tissue thickness. If gum disease is present, it must be treated and stable before proceeding. We take photographs to document your baseline and confirm the treatment plan.

During

Comfortable, minimally invasive procedure

Performed under local anesthetic, the procedure is quiet and low-stress compared to traditional surgery. Most patients are surprised by how quick and comfortable it is. Multiple areas can be treated in the same session — often the full mouth in one visit.

After

Soft diet for 1–2 weeks, rapid recovery

Mild soreness and some swelling are normal for the first few days. Avoid hard or crunchy foods for 1–2 weeks. Most patients return to work the next day. We schedule a follow-up at 1–2 weeks to confirm the tissue is healing in position.

Common Questions

Frequently asked about the Chao Pinhole® Technique

How long do Pinhole results last?

Published clinical data shows Pinhole results are stable at 1 and 3 years, with outcomes comparable to traditional connective tissue grafting. Long-term durability depends on controlling the underlying cause of recession — whether that's aggressive brushing technique, gum disease, or bite forces. We address those contributing factors as part of treatment planning so the results are maintained.

Is the Pinhole Technique covered by insurance?

Coverage varies by plan. Many dental insurance plans cover gum recession treatment when it is medically necessary — protecting teeth from further recession, sensitivity, or root caries risk. The specific code used may differ from traditional grafting. We'll verify your benefits before treatment and provide a clear breakdown of any out-of-pocket costs.

How is this different from a traditional gum graft?

A traditional connective tissue graft harvests tissue from the roof of the mouth, which creates a second wound site that is often more painful than the primary graft site. It requires sutures and typically treats a limited number of teeth per session. The Pinhole Technique repositions existing tissue through a needle-sized opening — no harvest, no sutures, multiple teeth in one visit, and dramatically less post-operative discomfort.

Will my gums recede again after treatment?

Recession can recur if the underlying cause is not addressed. Common causes include overly aggressive brushing with a hard-bristle toothbrush, clenching or grinding, gum disease, and thin tissue biotype. As part of your treatment, we identify the contributing factors and provide guidance on technique changes or additional therapies (like a night guard) to protect your results long-term.