
When periodontal pockets are greater than 5mm, there is a high probability that the disease process will continue. In these cases, surgical procedures designed to reduce pockets as close to 2-3 mm as possible are often the best treatment. This will provide the patient the greatest potential for infection control by improving access to the bacterial plaque.
Gums prior to gum surgery
Gum surgery performed on upper gums
Gum surgery performed on lower gums
When periodontal pockets do not involve the bone, trimming excess gum tissue can be very effective. This procedure may also be used to improve smiles by creating symmetry and proportional tooth length.
This is one of the most common surgical procedures where incisions are made around the tooth and the gum tissue is pulled back slightly. This provides access to thoroughly remove all plaque and calculus. Irregularities of the bone caused by the disease are smoothed over and the tissue placed at a higher level around the tooth, closer to the bone. When the procedure is completed, dissolving sutures are used. A protective dressing often is placed around the necks of the teeth to cover the surgical area and to help secure the new gum-to-tooth relationship. You will need to be seen in 10-14 days to remove any remaining sutures and evaluate your healing.
By moving the gum closer to the bone, the pockets will be reduced or eliminated. However, the tooth will appear longer and the spaces between the teeth will be larger. In cosmetic areas, other treatment options may be considered depending on how much gum tissue is exposed (smile line).
Crown lengthening (or crown exposure) is required when your tooth needs a new crown or other restoration due to decay or fracture. The edge of the new restoration would be too deep below the gum tissue and not accessible. It is also usually too close to the bone or below the bone.
The procedure involves adjusting the levels of the gum tissue and bone around the tooth in question, to create a new gum-to–tooth relationship. This allows us to reach the edge of the restoration, ensuring a proper fit to the tooth. It should also provide enough tooth structure so the new restoration will not come loose in the future. This allows you to clean the edge of the restoration when you brush and floss to prevent decay and gum disease. The procedure essentially is osseous surgery on a smaller scale.
When the procedure is completed, dissolving sutures are used. A protective dressing often is placed around the necks of the teeth to cover the surgical area and to help secure the new gum-to-tooth relationship. You will need to be seen in 10-14 days to remove any remaining sutures and evaluate your healing.
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