When healthy, your supporting bone and gum tissue fits snugly around your teeth. When you have gingivitis, your gum tissue has become inflamed due to bacterial plaque but may be treated non-surgically. When this condition worsens, it may lead to an irreversible form of periodontal disease. These conditions are associated with inflammation and loss of your supporting bone and gum tissue, resulting in “pockets” or gaps around your teeth where these bacteria accumulate. As the disease progresses, the “pockets” get deeper and conditions deteriorate. These deep “pockets” are too deep to keep clean with daily home-care or professional cleanings. Increased tooth mobility and shifting, bad odor, bleeding gums, recession, and spacing between teeth are all signs of periodontal disease.
If surgical therapy has been recommended to treat your periodontal disease, a determination has been made that the tissues around your teeth may not be treated or repaired using non-surgical treatment. The following are the five types of surgical treatments commonly prescribed:
- Pocket Reduction Procedures
- Regenerative Procedures
Soft Tissue Grafts
- Cosmetic Gum Enhancement
- Soft Tissue Augmentation
- Dental Implants
Pocket Reduction Procedures
Pocket reduction is a procedure that facilitates access to diseased sites and improves long-term prognosis of teeth treated. The “pockets” are eliminated or minimized by trimming away infected gum, re-contouring uneven bone and removing disease-causing bacteria plaque and calculus. As the gum heals, it will follow the newly created bony contour and once again fit snugly around your teeth. Although efforts are made to minimize complications, disadvantages to this procedure include, but are not limited to, tooth sensitivity, longer “appearing” teeth, increased spacing between teeth, food traps and increased mobility.
Regenerative procedures eliminate existing bacterial plaque and calculus, and regenerate bone and supporting tissue previously lost. Procedures result in reduced pocket depth and “reverses” or repairs damage caused by progression of periodontal disease. The “pockets” are eliminated or minimized by the use of bone grafts, collagen membranes and proteins gels that stimulate your own body’s ability to regenerate bone and supporting tissues. Regeneration is indicated when grafting procedures are physically possible, when “pockets” are too deep for pocket reduction procedures and when patient is a non-smoker. Although efforts are made to minimize complications, disadvantages to this procedure include, but are not limited to, tooth sensitivity and an increased in healing time.
Crown lengthening procedures lay the groundwork for restorative and cosmetic dentistry and/or to improve the esthetics of your gum line and smile. The goal of this procedure is to create access and/or to expose adequate tooth structure to facilitate restorative procedures. Procedure is limited by surrounding structures, remaining root length, root shape, tooth mobility and location of needed crown lengthening procedure.
Cosmetic Crown Lengthening
To correct a “gummy” smile, or “short teeth”, excess gum and bone tissue is removed and reshaped to expose additional tooth structure to create a desired smile. Crown lengthened teeth may then be whitened, or restored with porcelain crowns and veneers for a complete smile makeover.
Conventional Crown Lengthening
When teeth are decayed, broken below the gum line or have inadequate tooth structure for restorations, crown lengthening procedures adjust the gum and bone level to expose more tooth structure to complete planned restorations. After a short healing phase, restorative treatment may be completed.
Soft Tissue Grafts
Soft tissue grafts can be used to cover roots or to develop gum tissue where absent due to excessive gingival recession. Your gums may have receded for a variety of reasons, including aggressive tooth brushing, anatomical discrepancies, or periodontal disease. You may not be in control of what caused the recession, but prior to treatment, contributing factors to your recession must be identified. Once these contributing factors are controlled, a soft tissue graft procedure will repair the defect and help prevent additional recession and bone loss.
During soft tissue graft procedures, tissue is taken from your palate or other donor sources to cover the exposed root. This can be done for one tooth or several teeth to cover roots, even your gum line, and reduce sensitivity.