Surgical Therapy

To treat the more advanced stages of periodontal disease, surgical therapy is usually necessary. 

A periodontist performs this procedure.  It involves gently lifting the gums to clean the infected pockets.   He or she also repositions the gums so that it will be easier to keep clean during homecare and follow-up appointments.  The gum-line often is lowered, which exposes more tooth.

Surgical Options Defined:

• Flap Surgery:  This procedure involves the separation of the gum from the tooth, creating a "flap", which allows a better access to the infected pocket.  This allows the periodontist to remove deep deposits of plaque and calculus (tartar).  There is little or no removal of gum tissue.              

• Gingivectomy:  This involves the removal of gingival overgrowth.  This procedure eliminates the space in which bacteria can collect and allows one to maintain and clean the area easier.

• Bone (Osseous) Surgery:  Sometimes it is necessary to perform this procedure when advanced periodontal disease has progressed to the point where the supportive structures are destroyed.  This procedure restores lost bone and ligaments, increasing the chance of saving unhealthy teeth.   Bone surgery is used to smooth shallow craters in the bone due to mild or moderate bone loss.  After flap surgery to gain access to the area, the periodontist reshapes the bone around the tooth to decrease the craters.  By smoothing the area, this makes it harder for the bacteria to accumulate and grow.

• Guided Tissue Regeneration:  To help keep unwanted gum tissue away from the tooth and bone, which allows the ligament fibers ( supporting tissues) to re-grow so that the tooth is better supported.

• Bone Graft:   This involves tiny fragments of your own bone, synthetic bone, or some from a bone bank are placed into the areas where bone was lost.  These act as platform on which bone can re-grow, restoring stability to  your teeth.

• Soft Tissue Graft:  To reinforce thin gums or to fill in areas where gums have receded, soft tissue is added.   This tissue is usually taken from the roof of your mouth and is sutured in place over the affected area.