An understanding of what periodontal surgery is designed to do, what makes it successful and what sustains the results over time is critical to successful treatment of periodontal disease. Periodontal surgery is not a cure, but rather an adjunct to making long-term treatment outcomes more favorable. Unlike surgery to take out an inflamed appendix, which removes the disease with it, the potential for the recurrence of periodontal disease still remains in susceptible individuals. The long-term goal of periodontal surgery is to increase the life expectancy of the teeth. Over a lifetime, the treatment for periodontal disease is primarily aimed at controlling its cause, microbial dental plaque. The purpose of periodontal surgery therefore is to treat deformities and tissue loss created by the disease process. This is accomplished by eliminating “pockets” of diseased tissue; regenerating and reconstructing gum and periodontal tissue attachment to the teeth and generally to provide an environment more conducive to daily oral hygiene and professional maintenance care.book An APPOINTMENT
Periodontal or “gum” surgery is needed when conservative non-surgical treatments are ineffective in completely eradicating periodontal disease. Luckily, periodontal surgery is a very simple and extremely effective technique to treat advanced periodontal problems.
Periodontal surgery is a simple procedure that allows your periodontist to access your teeth below the gum line in order to clean them better. In actuality, we are cleaning your tooth roots. This involves making small incisions at the gum line allowing the separation of the gum from the tooth, creating a “flap” of tissue. This is commonly referred to as a “flap” procedure or “flap” surgery. Once the gums are opened, the roots of the teeth and the bone loss created by the periodontal infection can be visualized. All plaque and calculus deposits are then removed, and the gums are then closed back together with sutures (stitches).
This picture shows the upper front teeth with a gum “flap” raised. The flap is pink and recognizable on the upper right part of the picture. The dark material on the middle tooth root is bacterial plaque and calculus which is the primary cause of periodontal disease. Bone can be seen surrounding most of the adjacent tooth roots with obvious bone loss around the middle tooth because of the plaque and calculus.
This is another example of an open flap procedure exposing plaque and calculus between the roots of the lower back teeth. Notice the large black tartar and the bone loss it has created.
Infections caused by periodontitis, often create loss of bone as well as defects in the bone surrounding the teeth. These bony defects, based on their size and shape, may require some additional forms of treatment such as bone recontouring during the flap procedure. This is known as “osseous surgery”. Sometimes, the defects can be repaired and the bone regenerated through a process referred to “guided tissue regeneration” which involves the placement of a sheet of material, referred to as a “membrane” around the bony defect allowing the defect to naturally fill in with bone and tooth ligament instead of gum tissue collapsing into the defect and filling in the defect with soft tissue. Some of these membranes are bio-absorbable and dissolve on their own and some require removal. Dr. Caplanis will let you know which procedure is right for you.
Guided Tissue Regeneration
PERIODONTAL BONE GRAFTING
In some situations, the bone can be repaired or regenerated through the placement of bone filler materials, or bone grafts. Other regenerative procedures involve the use of bioactive gels and proteins. Our doctors will let you know which treatment is right for you.