Daniel C. Harper, DMD
Eugene Periodontist

Periodontal Surgery


Periodontal Surgery at Daniel C. Harper, DMD Periodontal surgery is a blanket term for a procedure that addresses gum disease. Pocket reduction and grafting are two of the most common options. If you suffer from gingivitis or periodontitis, and non-surgical methods don't help to resolve it, periodontal surgery could rectify the problem. Read on to learn more about the surgical procedures we offer.

Scaling and Root Planing


One of the first treatment methods used to combat gum disease is scaling and root planing. This deep cleaning procedure is used to remove plaque and tartar from the teeth, especially when they are found under the gum line. Plaque and tartar are responsible for gum inflammation and a variety of other problems, so it is important to treat the issue thoroughly.

Scaling focuses on removing plague and tartar along the root and below the gum line. An ultrasonic scaling tool is used, and it includes an irrigation process that delivers antimicrobial agents to reduce bacteria.

Root planing is often done along with scaling. It involves removing cementum and surface dentin that might be housing unwanted microorganisms, tartar, and toxins. The root will be smoothed down in order to promote healing, and this also helps with preventing bacteria from colonizing there in the future.

What Are the Advantages?


Scaling and root planing are helpful in preventing disease, as the bacteria from gum infections can travel through the blood to affect other parts of the body. The procedure also protects from tooth loss, especially when deep pockets have formed between the teeth and the gums.


Crown Lengthening


Crown lengthening (AKA: "crown-elongation" or "crown-extension") is a surgical procedure that is done when the tooth is too short to provide adequate retention for a restoration (usually a crown).

When a tooth has a deep cavity, a crown and buildup are usually needed to restore the tooth. If the cavity extends too far below the gums, it becomes impossible to predictably make a crown that will last for any length of time. Performing crown lengthening where indicated improves the prognosis for the tooth.

Crown lengthening nearly always involves removing and recontouring some of the bone around the tooth. This results in more tooth structure above the gums and smooth flowing gum contours. Not every tooth that needs a crown also needs crown lengthening surgery, it is only necessary when a deep cavity or crack is present.

First, the dentist or periodontist will thoroughly numb the tooth or teeth needing crown lengthening. During this procedure, excess gum and bone tissue is reshaped to expose more of the natural tooth. After the procedure your dentist can now prepare the tooth for a functional, long lasting crown. As always, proper brushing and flossing is key to insuring the maximum life of your new crown.


Bone Grafting


Bone grafting is a surgical procedure that is used to fix problems associated with the bone or joints. It involves transplanting bone tissue, and in the field of dentistry, it is most commonly completed so that there is enough bone available to support dental implants. Bone grafting is essential in repairing implant sites to contain adequate bone structure. This may be needed due to tooth loss, previous extractions, trauma, or gum disease. The bone will either be harvested from somewhere else in your body, such as the tibia, hip or jaw, or it can be taken from a cadaver or animal source. Special membranes are also used to encourage bone regeneration and bone grafts, and the most successful regeneration efforts will occur when using live bone from your own body.

Major bone grafting is usually performed in order to repair jaw defects. These may have resulted from congenital defects, tumor surgery, or some type of traumatic injury. The largest defects are typically corrected using the patient’s own bone, and the procedures are generally performed in an operating room and may require an overnight hospital stay.

Benefits of Bone Grafting


Bone grafting will be done to restore the bone in your jaw to its previous form, and it may also be used to maintain the existing bone structure after you have had teeth extracted. These activities are important for several reasons. First, dental implant placement will require that the bone of the jaw is as close to the original dimensions as possible in order to achieve optimal results. Additionally, the jaw and facial bones will support the muscles and skin that make up your facial shape and appearance, and without this underlying support, your face may look prematurely aged.


Tissue Graft


When you are suffering from advanced gum disease, you may notice that your gums start to pull away from your teeth. This can lead to increased sensitivity and a host of other problems, so you will need to work with your periodontist to treat the issue before it can progress.

Treating Your Gum Recession


There are several ways that your gum recession can be treated. First, a professional cleaning can be used to stop the recession. This procedure is known as scaling and root planing, and it can help the gums to heal so that they don't recede further.

If you need more extensive treatment, a gum graft is often recommended. According to the American Academy of Periodontology, this option can repair the wounded areas where recession has occurred, and it can also help to prevent future infections.

Types of Grafts


There are several different types of gum grafts available if this is the treatment option that you need to pursue, and your periodontist will help you to choose the right option:

•  Connective tissue grafts: This is the most common grafting procedure, and it takes tissue form the roof of your mouth before stitching it over the exposed root.
•  Free gingival graft: Similar to the connective tissue grafts, this option involves taking tissue directly from the palate.
•  Pedicle graft: This option uses tissue found next to the tooth that needs a repair in order to perform the graft.

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