Periodontal Surgery

Periodontal or “gum” surgery is needed when conservative non-surgical treatments are ineffective in completely eradicating periodontal disease. Luckily, periodontal surgery is a very simple and extremely effective technique to treat advanced periodontal problems.

before-periodontal-surgery after-periodontal-surgery

Periodontal surgery is a simple procedure that allows your periodontist to access your teeth below the gum line in order to clean them better. In actuality, we are cleaning your tooth roots. This involves making small incisions at the gum line allowing the separation of the gum from the tooth, creating a “flap” of tissue. This is commonly referred to as a “flap” procedure or “flap” surgery. Once the gums are opened, the roots of the teeth and the bone loss created by the periodontal infection can be visualized. All plaque and calculus deposits are then removed, and the gums are then closed back together with sutures (stitches).

root-with-calculus

This picture shows the upper front teeth with a gum “flap” raised. The flap is pink and recognizable on the upper right part of the picture. The dark material on the middle tooth root is bacterial plaque and calculus which is the primary cause of periodontal disease. Bone can be seen surrounding most of the adjacent tooth roots with obvious bone loss around the middle tooth because of the plaque and calculus.

open-flap-bacteria

This is another example of an open flap procedure exposing plaque and calculus between the roots of the lower back teeth. Notice the large black tartar and the bone loss it has created.

Infections caused by periodontitis, often create loss of bone as well as defects in the bone surrounding the teeth. These bony defects, based on their size and shape, may require some additional forms of treatment such as bone recontouring during the flap procedure. This is known as “osseous surgery”. Sometimes, the defects can be repaired and the bone regenerated through a process referred to “guided tissue regeneration” which involves the placement of a sheet of material, referred to as a “membrane” around the bony defect allowing the defect to naturally fill in with bone and tooth ligament instead of gum tissue collapsing into the defect and filling in the defect with soft tissue. Some of these membranes are bio-absorbable and dissolve on their own and some require removal. Dr. Caplanis will let you know which procedure is right for you.

Guided Tissue Regeneration

guided-tissue-regeneration guided-tissue-regeneration-pre

PERIODONTAL BONE GRAFTING

In some situations, the bone can be repaired or regenerated through the placement of bone filler materials, or bone grafts. Other regenerative procedures involve the use of bioactive gels and proteins. Our doctors will let you know which treatment is right for you.

bone-graft-repair bone-graft

Surgeries are performed in our specially designed and equipped “surgi-suites” where you can watch a TV program or movie, or listen to music on personal headphones. Or if you wish, you can sleep through your procedure by having a “twilight sleep” procedure, or intravenous sedative.