Before reading this section, it will be helpful to be familiar with Periodontal Disease.
Periodontal surgery is a second phase treatment for moderate to advanced periodontal disease. Following scaling and root planing (phase 1), residual probing depths of 5mm or greater may remain at your re-evalution appointment. While these areas may feel clean at that time, a 5mm probing depth is not something that is maintainable long-term. It is too deep to clean at home (brush bristles and floss only reach 2mm below gum line), and it is simply too deep to clean effectively every time at your regular maintenance (cleaning) visits every 3 months. In addition to cleansability (or lack thereof), 5mm probing depths are more anaerobic (less oxygen), and harbor more pathogenic (disease causing) bacteria. The combination of these two factors essentially means that the disease process is allowed to continue if no further treatment is performed .
Fortunately, periodontal surgery can correct many of these deep residual probing depths. Periodontal surgery simply involves making incisions around the necks of the teeth and reflecting the tissue back to have access to the underlying roots and hard tissue. Once access is achieved, meticulous debridement of the roots can be completed. Following debridement, bone grafting can sometimes be utilized to build support back around the teeth. Where boen grafting cannot be done, the tissue can physically be positioned to create shallower probing depths. The end result is a probing depth that is cleansable, and a tooth that is maintainable long-term.
Periodontal Surgery can include the following:
Access for debridement: Simply reflecting the tissue to access root surface for debridement
Pocket Reduction: This involves removing diseased and unsupportive tissue to physically reduce probing depths
Pocket Reduction with Osseous Recontouring: This involves removing diseased and unsupportive tissue and reshape underlying bone for intimate tissue attachment and ultimate probing depth reduction
Guided Tissue Regeneration with Bone (Regeneration): This involves facilitating proper tissue reattachment to regenerate lost bone, cementum, and periodontal ligament.
Gingivectomy: Similar to Pocket Reduction, this involves removing unsupportive or overgrown tissue to facilitate probing depth reduction