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Surgical Periodental Treatment
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When routine scaling and root planing does not help to restore periodontal health
periodontal surgery may be advised. Most common surgical procedures are:
• Pocket reduction procedures
• Regenerative Procedures
Pocket Reduction Procedures
When with routine scaling and root planing deep periodontal pockets cannot be cleaned
your periodontist may recommend pocket reduction procedures. During this procedure,
your periodontist folds back the gum tissue and removes the disease-causing plaque
and tartar. In some cases, irregular surfaces of the damaged bone are smoothened.
This allows the gum tissue to better reattach to healthy bone. The gum tissue is
then secured at its new position with sutures.
Reducing pocket depth and eliminating existing bacteria are important to prevent
damage caused by the progression of periodontal disease and to help you maintain
a healthy smile. Eliminating bacteria alone may not be sufficient to prevent disease
recurrence. Deeper pockets are more difficult for you and your dental care professional
to clean, so it's important to reduce them. Reduced pockets and a combination of
daily oral hygiene and professional maintenance care increase your chances of keeping
your natural teeth – and decrease the chance of serious health problems associated
with periodontal disease.
Regenerative Procedures
Bone Graft and Guided tissue Regeneration
If there is a defect in the bone, often times a bone graft can be placed to stimulate
new bone formation. A combination of natural or synthetic bone can be used for regeneration.
Sometimes specialised membranes may be used during this procedure to prevent the
gum tissue from creeping in between the tooth and the bone. This helps allow a regeneration
of new bone and periodontal ligament.
Cosmetic Surgical Procedures
Crown Lengthening
This procedure involves the removal of gum tissue (gingiva), bone or both to expose
more of a tooth's structure.
What it's Used for
Crown lengthening is done when a tooth needs to be restored, but not enough tooth
is present to support a crown or a filling
This can happen when a tooth breaks off at the gum line, or a crown or filling falls
out of a tooth that has extensive decay underneath. If your dentist wants to repair
the tooth using a crown or a large filling, he or she may need to expose more of
the tooth by removing some soft tissue and/or bone.
In some cases, a condition called gummy smile —in which an unusually large amount
of gum tissue shows around the upper teeth —can be treated using crown lengthening.
Procedure
This procedure is usually done under local anesthesia. Incisions are made to reflect
the gums away from the teeth. This provides access to the roots of the teeth and
the bone that surrounds them. In some cases, by simply removing a little gum tissue
when the incisions are made enough tooth structure will be exposed for your dentist
to place a crown of filling. However, in most situations it will also be necessary
for the periodontist to remove some bone from around the roots of the teeth. The
bone is removed using a combination of hand instruments (resembling chisels) and
rotary instruments (similar to the drill and burs used to treat cavities).
Then the gum tissue is secured with sutures. At this point, your teeth will look
longer because the gums are now sitting at a lower level then before the surgery.
Sometimes a periodontal dressing may be used —an intraoral bandage —to cover the
surgical site. It helps protect the surgical site and aids in healing.
Any temporary crowns will be removed before the procedure begins and replaced afterward.
Soft tissue Grafts
Soft tissue grafts are used for treating gum recession, and/or to improve the esthetics
of your gum line.
Gum Recession could be due to a variety of reasons including aggressive tooth brushing,
periodontal disease or clenching of teeth.
Exposed tooth roots are the result of gum recession. Gum recession makes your teeth
longer giving an older look. Also since the roots are exposed your teeth will be
sensitive to cold liquids and foods. Soft tissue grafts can easily eliminate this
problem.
Soft tissue grafts can be used to cover roots or develop gum tissue where absent
due to excessive gingival recession. During this procedure, your periodontist takes
gum tissue from your palate or another donor source to cover the exposed root. This
can be done for one tooth or several teeth. A soft tissue graft can reduce further
recession and bone loss. It also protects the root from decay and reduces sensitivity.
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