Traditionally, gum disease is 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.
Open Flap Curettage
The basic procedure known as open flap curettage involves the following:
The periodontal surgeon lifts, or flaps, the gums away from the tooth and surrounding bone.
The diseased root surfaces are cleaned and curetted (scraped) to remove deposits.
Gum tissue is replaced into position to minimize pocket depth.
The surgeon may also contour the remaining bone (osseous surgery) and attempt to regenerate lost bone and gingival attachment through bone grafts and guided tissue regeneration.
This surgical procedure "regenerates" the previously lost gum and bone tissue. Most techniques utilize membranes, which are inserted over the bone defects. Some of these membranes are bio-absorbable and some require removal. Other regenerative procedures involve the use of bioactive gels.
When recession of the gingiva occurs, the body loses a natural defence against both bacterial penetration and trauma. When gum recession is a problem gum reconstruction using grafting techniques is an option.
When there is only minor recession, some healthy gingiva often remains and protects the tooth, so that no treatment other than modifying home care practices is necessary. However, when recession reaches the mucosa, the first line of defence against bacterial penetration is lost.
In addition, gum recession often results in root sensitivity to hot and cold foods as well as an unsightly appearance to the gum and tooth. Also, gum recession, when significant, can predispose to worsening recession and expose the root surface, which is softer than enamel, leading to root caries and root gouging.
A gingival graft is designed to solve these problems. A thin piece of tissue made from animal collagen, Tissue Bank or 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. The gingival graft may be placed in such a way as to cover the exposed portion of the root. The gingival graft procedure is highly predictable and results in a stable healthy band of attached tissue around the tooth.
When decay occurs below the gumline, it may be necessary to remove a small amount of bone and gum tissue. Your dentist may ask for this procedure before he or she makes a new crown for your tooth.
Reshaping The Gum and Supporting Tissues: This will allow your general dentist adequate room to place a quality final restoration.
Final Restoration: Another indication for crown lengthening is when the front teeth are too short or of uneven length.