NON SURGICAL TREATMENT
Some forms of periodontal disease can be treated through non-surgical periodontal treatment, including scaling and root planing (Deep cleaning -- a careful cleaning of the root surfaces to remove plaque and calculus from deep periodontal pockets and to smooth the tooth root surface to remove bacterial toxins), followed by adjunctive therapy such as local antibiotic delivery and host modulation, as needed on a case-by-case basis.
Non-surgical therapy does have its limitations, however, and when it does not achieve periodontal health, surgery may be indicated to restore periodontal anatomy damaged by periodontal diseases and to facilitate oral hygiene practices.
Periodontal surgery is necessary when the tissue around your teeth is unhealthy and cannot be repaired with non-surgical treatment. Following are the four types of surgical treatments most commonly prescribed:
The infected gum tissue is surgically removed and uneven bone tissue re-contoured. Bone regeneration techniques may be advised during this procedure to gain further attachment.
Guided Tissue/Bone Regeneration procedure can regenerate previously lost gum and bone tissue by the use of bone graft material being inserted into the carefully degranulated bony defect. This procedure is defect specific and is advised on a case-by-case basis.
Crown lengthening (or clinical crown exposure) may be required when the tooth needs a new crown or other restoration and that the margin of the new restoration is deep below the gum tissue and is not accessible. Crown lengthening involves adjusting the levels of the gum tissue and bone around the tooth in question to create a new gum-to-tooth relationship. This allows the restorative dentist to gain access to the margin of the new restoration, ensuring a proper fit to the tooth. The procedure also provides additional tooth structure for the new restoration to be in contact with the tooth, thus increases the retention of the new restoration.
Cavity below gum line
Post-op: Cavity above gum line
Soft Tissue Grafts
When there is recession of the gums around the tooth, this may cause significant loss of structural support to the tooth structure. A gingival graft is designed to solve these problems. A thin piece of tissue is taken from the roof of the mouth or gently moved over from adjacent areas to provide a stable band of attached gingiva around the tooth. Other sources of graft tissue taken from external sources are also available. The gingival graft may be placed in such a way as to cover the exposed portion of the root. The gingival graft procedure may result in a stable healthy band of attached tissue around the tooth.
Gingivectomy is the surgical removal of excess gum tissue. Excess growth of gum tissue can be caused by certain medicines. Sometimes there is no apparent cause. This procedure can also be used to remove amalgam tattoo (dark gum tissue surrounding metal restorations).
Overgrown gum tissue
Overgrown gum tissue
Amalgam Tattoo Removal
These procedures are a predictable way to cover unsightly, sensitive, or exposed root surfaces and to prevent future gum recession. Or, if you are unhappy with the appearance of short unsightly teeth, this can be greatly improved by a combination of periodontal procedures by your periodontist (Dr. Ziar) and cosmetic dentistry by your general dentist.
Esthetic Crown Lengthening
Although your teeth may appear short, they may actually be the proper length. The teeth may just be covered with too much gum tissue. We can correct this by performing the periodontal plastic surgery procedure, crown lengthening.
During this procedure, excess gum and bone tissue is reshaped to expose more of the natural tooth. This can be done to more than one tooth to even your gum line and to create a beautiful smile.
Uneven gum line
Gum line re-contoured
Crown-Lengthening & Veneers
Soft Tissue Grafting
It is used to cover unattractive tooth roots, reduce gum recession, and protect the roots from decay and eventual loss.
Bone grafting following tooth loss can preserve the socket/ridge and minimize gum and bone collapse. There is less shrinkage and a more esthetic tooth replacement for either an implant crown or fixed bridge around the replacement teeth.