Periodontics

Gum Disease

Gum sickness is an infection of the gums which could progress to have an effect on the bone that helps your enamel. Because gum disease is commonly painless, you can no longer recognize you have it. It is also known as periodontal sickness, gum disease is as a result of plaque, the sticky film of micro organism this is continuously forming on our enamel.

Here are some warning signs that can signal a problem:

1. Gums that bleed easily.
2. Gums that have pulled away from the teeth.
3. Red, swollen, tender gums.
4. Persistent bad breath or bad taste.
5. Permanent teeth that are loose or separating.
6. Any change in the way your teeth fit together when you bite.
7. Any change in the fit of partial dentures.

Gingivectomy

The procedure is used in order to treat gum disease or to lengthen the height or width of a tooth or a section of teeth. Here the total removal of a portion of your gums from in and around a tooth is done. It can be performed by a general dentist who has training in periodontal surgery. Another type of periodontal surgery is known as gingivoplasty. A gingivoplasty is different than a gingivectomy as the former only involves a partial removal of the gums. The latter removes an entire portion of a gum section.

Surgeries are completed with a surgical scalpel; however, in some instances a low-frequency laser may be employed instead. The diseased tissue is trimmed and removed, the remaining gums are reattached in and around the teeth by stitches, and the area is cleaned with saline and special rinses. A local anesthetic is used to keep the patient comfortable during the procedure. After the procedure is completed, a surgical dressing, or pack, is placed in and around the teeth and gums. This dressing is left in place for about a week. Swishing with an antibacterial mouthwash can help in the healing process.

Scaling and Root planing

Scaling removes plaque and tartar from below the gum line. Root planning smoothes the tooth root and helps the gums reattach to the tooth. scaling and root planning is a deep cleaning below the gum line used to treat gum disease. A sticky film of bacteria causes gum disease called plaque. Plaque is continually forming to your tooth, however if they aren't wiped clean properly, the bacteria in plaque can purpose your gums to come to be infected. Plaque then gets trapped in those wallet and can not be removed with normal brushing. If untreated, gum sickness should cause bone and teeth loss.

If gum disease is caught early and hasn't damaged the structures below the gum line, a professional cleaning is required. A scaling and root planning may be needed if the pockets between your gums and teeth are too deep.

This deep cleaning has two parts. In Scaling, your dentist removes all the plaque and tartar (hardened plaque) above and below the gum line, making sure to clean all the way down to the bottom of the pocket. Your dentist will then begin root planning, smoothing out your teeth roots to help your gums reattach to your teeth. Scaling and root planning may take more than one visit to complete and may require a local anesthetic.

Flap surgery

In flap surgery, gums are separated from the teeth and folded back temporarily to enable a dentist to reach the root of the tooth and the bone. Gingival flap surgery is used to treat gum disease (periodontitis). If the initial, non-surgical treatment (scaling and root planning) has not eliminated the gum infection, flap surgery may be recommended for people with moderate or advanced periodontitis.

Your dentist will first remove all plaque and tartar from around your teeth and make sure that your oral hygiene is good. Your periodontist will determine before the surgery whether your general health or your current medications allow for a surgical procedure to be carried out.

Curettage

It has been used to treat teeth affected by periodontitis. It is removal of dead inner tissue from a gum pocket. In dentistry there are different types of curettage procedures and these are mentioned below:

This is the removal with a curet (a spoon-shaped instrument for removing material from the wall of a cavity or other surface) of the inflamed tissue wall of a periodontal (area surrounding a tooth) pocket.

This is the removal with a curet of diseased soft tissues in the bony area surrounding a tooth root apex and smoothing of the top surface of a tooth without excision of the tooth tip.

This is a slightly different form of gingival curettage.

This is a flap procedure and it removes an inflamed periodontal pocket wall and the connective tissue attachment followed by reattachment of the flap to the teeth.

This is the removal of inflamed tissue from the tooth surface and wall of the gingival fissure with an ultrasonic scalar.

Bone graft

When bone is destroyed by gum disease, it can no longer adequately support the teeth, eventually leading to total tooth loss. In these cases, a periodontist may recommend bone grafting also known as regenerative surgery. During this procedure, a prepared graft is placed in the areas where bone should be, which encourages the body to rebuild the areas lost to periodontal disease.

More and more patients are undergoing bone graft procedures to gain enough bone structure to support dental implants. Bone beneath the gums naturally deteriorates following tooth loss. Bone grafting rebuilds these ridges and makes it possible for many patients to get permanent tooth prosthetics instead of dentures.

Splinting

Splinting is a technique that is used to stabilize teeth which have become loose as a result of losing the supporting bone around them to gum disease. Excessive mobility can cause discomfort when biting and eating.

If your teeth are mobile enough to require splinting, another factor that comes into play is the status of the gum disease. If you have active disease, and the bone around the teeth is softened from inflammation, simply bringing the disease under control through other types of periodontal disease management can make the teeth less mobile. A fibre ribbon splint is usually used, which is tooth colored and very comfortable.

Guided Tissue Regeneration

Teeth are held in place by surrounding gums, bone, and other tissues. But periodontal disease can lead the bone to break down. Certain techniques called regenerative procedures can be used to stimulate growth of new bone. In order to give the tooth more support, this growth increases the height of the bone around the tooth. Getting back even half the lost bone height extends the life of the tooth. One type of regenerative procedure is called guided tissue regeneration (GTR).

Cosmetic Gum surgery

There are many components that make up an ideal smile; bright, healthy-looking teeth immediately come to mind. But the gum tissue that surrounds and supports those teeth also plays a big role in how appealing your smile will look.

There are various cosmetic problems involving gum (gingival) tissue. For example, your smile may look “gummy”, it means that you seem to display too much gum tissue when you smile, or your teeth appear too short. Sometimes it's the opposite problem that your teeth seems to appear too long because your gum tissue has receded (pulled back), exposing tooth-root surfaces that were covered at one time. Or, you may have an uneven gum line, meaning gum tissue covers some of your teeth more than others. All of these cosmetic gum problems can be successfully treated with cosmetic procedures by your dentists.

Cosmetic gum surgery for gum recession usually includes a skin graft where the dentist or periodontist removes tissue from the roof of the mouth and grafts it onto the gum line. This provides improved support for thin gums and fills in gaps and places where the gums have receded.

Papilla Reconstruction Procedure

Modern dentistry includes not only the restoration of lost teeth and their associated hard tissues, but increasingly the management and reconstruction of the encasing gingiva with adequate surgical techniques like Papilla Reconstruction Procedure.

The open gingival embrasure, also called the “black triangle,” is a visible triangular space caused by the lack of interdental gingival papilla filling this area. These Black Triangles appear extremely unaesthetic and are unacceptable. Several surgical and non-surgical procedures have been proposed to treat the soft tissue deformities in the interproximal area.