Pocket Reduction Surgery
Periodontal disease, if left untreated, can lead to the destruction of supporting structures such as bone and connective tissue, causing teeth to become loose or even fall out. Pocket reduction surgery aims to halt the progression of the disease by accessing and cleaning the roots of the teeth, removing diseased tissue, and reshaping the bone to promote healing.
Periodontal disease, if left untreated, can lead to the destruction of supporting structures such as bone and connective tissue, causing teeth to become loose or even fall out. Pocket reduction surgery aims to halt the progression of the disease by accessing and cleaning the roots of the teeth, removing diseased tissue, and reshaping the bone to promote healing.
Osseous Surgery
Periodontitis is a disease that causes destruction of the supporting structures around teeth that includes bone. The disease erodes away bone in a manner that leaves irregularities to the normal physiologic bony architecture. Osseous surgery is a term that encompasses a group of procedures to treat periodontal disease. Osseous surgery is used to reshape deformities and remove pockets in the alveolar bone surrounding the teeth. The procedure is also known as pocket reduction surgery, or flap surgery. In some cases, bone replacement grafts can be used to regenerate areas where bone has been lost. Osseous surgery is a common necessity in effective treatment of more advanced periodontal diseases. The ultimate goal of osseous surgery is to reduce or eliminate the periodontal pockets that cause periodontal disease. Despite the word “surgery” the procedure is more like a thorough cleaning with direct access and visibility to the diseased areas of the teeth.
After the procedure, the bone and gum tissue around teeth is placed at a level that is most conducive to oral hygiene practices such as brushing, flossing, and the use of aids to clean in between teeth. To maintain the results of the procedure, we demonstrate to our patients how best to utilize oral hygiene tools tailored to each individual patient.
Guided Tissue Regeneration
Gum disease has traditionally been treated by eliminating the gum pockets by trimming away the infected gum tissue and by re-contouring the uneven bone tissue. Although this is still an effective way of treating gum disease, new and more sophisticated procedures are used routinely today. One of these advancements guided tissue regeneration. This procedure is used to stabilize endangered teeth.
As periodontal disease progresses, pockets of degenerated bone develop in the jaw. These pockets can promote the growth of bacteria and the spread of infection. To address these pockets, Dr. Farris, Dr. Gonzalez, Dr. Sharma, Dr. Little may recommend periodontal regeneration. During this surgical procedure, the pockets are cleaned thoroughly, a bone graft and/or a membrane is inserted between the soft tissue and the defect in the bone. These membranes are bio-absorbable. The membrane covers the pocket so that fast-growing soft tissue is blocked, and slower-growing bone can begin to grow, or “regenerate” itself.
Gingivectomy
The gum tissue can be very thick and large covering the tooth surface making the teeth look short. This can happen because of medications, bone that extends too close to the surface of the teeth, or inflammation due to gum disease.
Our team will anesthetize the area(s) to be treated. The excess of gum tissue is removed either with a scalpel blade and sometimes some rotary instruments or a laser. In most cases no sutures (stitches) are required. The surgical sites will be sore for 24-48 hours, and medication will be provided to alleviate any discomfort experienced. A week follow-up appointment is usually needed to ensure proper healing.
Frequently Asked Questions
Frequently Asked Questions
What is Osseous, or Periodontal Surgery?
Osseous surgery is a procedure that provides access to clean pockets that are too deep to reach with scaling and root planing, known as a “deep cleaning”. The gum tissue is gently reflected so that the roots of the teeth can be seen. Calculus, or bacteria that has hardened to the root surface, is a brown color under the gum tissue. It attaches to the white root surface and can be visualized and thoroughly cleaned with this procedure. Osseous surgery also gives us access to add a bone graft material to regenerate the lost bone around the teeth.
What is Bone Grafting?
The bone graft that we use is a donor or cadaver bone graft. It is real bone that has been sterilized and processed so that all of the cellular components are removed. There is no immune reaction to the bone graft. We draw blood from the patient prior to beginning the procedure to concentrate the healing cells and growth factors using platelet-rich fibrin (PRF). The patient’s own growth factor concentrate is mixed with the sterilized bone graft particles to make a bone putty. This accelerates the healing and makes the bone graft easy to work with and to shape to the defects around the teeth.
What is a Dental Implant?
An implant is a titanium post that replaces the root of the tooth. Implant dentistry involves teamwork between your restorative dentist and your periodontist. First, the implant is placed in the bone by your periodontist. Once the implant has healed, your general dentist creates a tooth that screws into the implant. An implant provides a fixed (non-removeable) option to restore a missing tooth without compromising the adjacent teeth. It is a single-tooth solution to a single-tooth problem.
What is Crown Lengthening?
When decay or a fracture extends below the gum line, crown lengthening is indicated to allow your restorative dentist access to the lesion. Crown lengthening removes gum and bone tissue to expose additional healthy tooth structure. It makes the tooth longer so that there is more tooth structure to work with and to retain the crown. Without crown lengthening, the crown margin may be located too deep under the gum tissue for proper cement isolation and access to remove all decay. Crown lengthening improves retention of the restoration and keeps the crown from falling off over time. Crown lengthening can also be done for esthetic reasons to lengthen anterior teeth and enhance gingival symmetry.