The objective of this procedure is to reestablish the seal of the gum to the tooth. When the gum is separated, bacteria and food debris, can build up in this space. This material is impossible to completely remove, even with the most careful brushing and flossing techniques, since it is behind and far under the gum tissue. Therefore, our goal is to create a new seal or attachment of the gum back to the tooth. This will protect the remaining underlying bone, and if kept clean and healthy, will hopefully enable you to preserve your teeth indefinitely.
The gum is gently lifted away from the teeth. The damage to the underlying from the previous infection is then corrected by smoothing the bone to its original contour. The gum tissue is then placed at the level of the bone to reestablish its seal to the tooth and to provide protection of the bone. Stitches are usually required and a dressing is often placed around the area. You can expect some of your teeth to look and feel slightly longer and the spaces between your teeth to be somewhat larger. You will now be able to clean the entire tooth with your brush daily.
The goal of periodontal therapy is to restore diseased tissue to a healthy state. For more advanced types of periodontal disease, a special type of gum surgery may be required in order to attempt to rebuild tissue that has been previously destroyed. This procedure is called periodontal regeneration.
Normally, during periodontal surgery, the gum tissue is opened to expose the damaged underlying bone support. If the damage is minor, the bone can be smoothed over much like a scratch in a piece of furniture can be sanded down. In that way, we create a smooth floor of bone to support the carpet of gum tissue and its seal of gum to tooth.
Unfortunately, in more advanced stages, the damage to the bone is so severe that smoothing it out becomes impossible. In these cases, we try to fill in the areas of bone destruction with new bone material. This material, made up of freeze-dried demineralized bone, provides a framework for your body to regenerate its lost bone support. Studies have shown that this material is highly effective in accomplishing this task. In addition, the grafted material completely vanishes in less than a year and is replaced by your body's own bone structure. The material that is used for the bone graft has an extraordinary safety record. This bone material has been used in modern periodontics for over 30 years, in millions of cases, with not one case where any infection has been transmitted.
Our bone material is obtained from the American Red Cross Tissue Bank. This freeze-dried demineralized allogenic bone material is obtained under sterile conditions from carefully-screened donors. Studies have shown that this material, in its freeze-dried form, has less than a one in eight million chance of transmitting any living particles (such as the hepatitis or AIDS viruses). In addition, the material is then pulverized and kept in alcohol for 30 minutes (it has been proven that the AIDS virus is killed in 10 minutes with the use of this technique). The material is then demineralized by immersion in a concentrated solution of hydochloric acid for three to eight hours (studies have shown that such a solution kills all viruses and microorganisms on contact!).
What is Soft Tissue Augmentation?
The zone of gum tissue is the defense mechanism of your mouth. It is this tissue that maintains the seal of the gum to the tooth, preventing plaque from getting under the gum and destroying the underlying bone support. When this tissue is thin or completely absent, this defense mechanism is no longer effective.
Studies have shown that inadequate zones of gum tissue to not break down in a regular pattern. Usually, it stays stable for a non-specified period of time. Then, once it has been irritated by some factor, it breaks down and recedes significantly down the root. The irritant that causes this recession may be a toothbrush, hard food, a filling, braces, a crown, gum infection, or other factors. Once this tissue has receded (and the tooth looks longer), it is very difficult to place new gum tissue back to the original height.
A gum graft is performed in order to correct this problem, protect the underlying bone, and prevent the gum tissue from receding even further. The goal is to create a new zone of defense (gum tissue). The longer tooth, caused by recession, is extremely difficult to cover up again once it is exposed. There are, however, special circumstances and procedures where exposed roots can be covered.
Once the areas are numb, a small piece of gum tissue is gently taken from around the necks of the teeth on the palate. This area heals "like a scraped elbow" and grows back, leaving sufficient gum tissue there. The piece of gum tissue taken from the palate is used to replace the weakened tissue of the tooth being grafted. The gum graft is placed over the root, at the level of the old receded gum tissue and held on by either resorbable stitches or a special biological glue. This area will heal with a thicker, more dense gum tissue which will protect the underlying jaw bone. A dressing is placed on the palate and the grafted area and will remain for a period of one to two weeks.
What is Tooth Exposure?
Many times a tooth is decayed or broken below the gum line. On other occasions, the gum has never receded back properly to the correct position. This results in a tooth that is "too short" for a crown to be retained. Periodontal surgery is needed to adjust the gum level and expose more tooth so that your dentist can construct a cap or bridge that will fit properly.
The gum is gently lifted away from the teeth. The underlying bone is recontoured to expose adequate tooth structure. The gum tissue is then placed at the level of the bone to reestablish its seal or attachment to the teeth. Stitches are usually required and a dressing is often placed around the area.
Guided Tissue Regeneration
The goal of periodontal therapy is to restore diseased tissue to a healthy state. In more advanced cases of periodontal disease, a special type of gum surgery may be required to rebuild tissue that has been destroyed. This procedure is called Guided Tissue Regeneration.
The biologic principle is to keep unwanted tissues away from the tooth and allow only desirable tissues to grow in their place. This allows regeneration of lost attachment fibers to occur. A special piece of material is used in this procedure as a barrier. The gums are then put back into place so that they cover the material. At this point the gums are sutured back into position. The healing process is similar to conventional periodontal surgery. Some types of barrier material resorb over time, other types may need to be removed later.