(a) Flap
Surgery
Surgery might be necessary if inflammation and deep
pockets remain following treatment with deep cleaning and medications. A
dentist or periodontist may perform flap surgery to remove tartar deposits in
deep pockets or to reduce the periodontal pocket and make it easier for the
patient, dentist, and hygienist to keep the area clean. This common surgery
involves lifting back the gums and
removing the tartar. The gums are then sutured back in place so that the tissue
fits snugly around the tooth again.
After surgery the gums will heal and fit more tightly around the tooth. This
sometimes results in the teeth appearing
longer.
(b) Bone and Tissue Grafts
In addition to flap surgery, your periodontist or
dentist may suggest procedures to help
regenerate any bone or gum tissue
lost to periodontitis. Bone grafting, in which natural or synthetic bone is
placed in the area of bone loss, can help promote bone growth. A technique that can be used
with bone grafting is called guided tissue regeneration. In this
procedure, a small piece of
mesh-like material is inserted between
the bone and gum tissue. This keeps the gum tissue from growing into the area where the bone should be, allowing
the bone and connective tissue to regrow.
Growth factors – proteins that can help your body naturally regrow bone
– may also be used. In cases where gum tissue has been lost, your dentist or periodontist may suggest a soft
tissue graft, in which synthetic material
or tissue take from another area of your
mouth is used to cover exposed
tooth roots.
Since each case is different, it is not possible to predict with certainty which grafts will
be successful over the long-term. Treatment
results depend on may things,
including how far the disease has progressed,
how well the patient keeps up with oral care
at home, and certain risk factors, such as smoking, which may lower the chances of success.
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