Periodontal Surgery

About periodontal surgery: Information for patients: If you are a patient with moderate-to-severe periodontal disease the optimal treatment for your disease may involve periodontal surgery.
To help you understand your disease and and feel comfortable with the prescribed treatment we outline some of the procedures below.

Pocket Reduction Therapy:
Osseous Sugery

Pocket Reduction Therapy-Osseous Surgery

Pocket reduction therapy may be required if:

You have periodontal pockets greater than 4 mm in depth. These pockets contain bacterial plaque which places your gum tissue at risk for chronic infection.
You have uncontrolled accumulation of plaque below the surface of the gum which has resulted in bone destruction and deepening of pockets.

Pocket reduction therapy, which includes scaling and root planing for mild periodontitis and osseous surgery for more severe disease, will reduce the risk of your periodontal disease progressing by:

Allowing Dr. Richards to fold back the gum tissue and remove the disease-causing bacteria before securing the tissue into place. In some cases he may smooth irregular surfaces of the damaged bone to limit areas where disease-causing bacteria can hide and allow the gum tissue to better reattach to healthy bone.
Reducing the depth of your periodontal pockets.
Your oral health will benefit from pocket reduction therapy for the following reasons:

When pocket depths are reduced, you and your hygienist will have better access to the tooth and root surfaces and they can be cleaned more easily.
As your periodontal health improves, any loose teeth will become more firmly anchored in your gums.

If you decide not to have treatment you risk the following:

Inability to keep your tooth and root surfaces clean.
Increased risk for additional bone loss (a 'vicious' circle - deepening of the pockets produces more space for bacterial plaque accumulation).
Your teeth will become looser.
You face an increased risk of developing a gum abcess.
Increased risk of tooth loss.: Pocket Reduction Therapy-Osseous Surgery

Pocket reduction therapy may be required if:

You have periodontal pockets greater than 4 mm in depth. These pockets contain bacterial plaque which places your gum tissue at risk for chronic infection.
You have uncontrolled accumulation of plaque below the surface of the gum which has resulted in bone destruction and deepening of pockets.

Pocket reduction therapy, which includes scaling and root planing for mild periodontitis and osseous surgery for more severe disease, will reduce the risk of your periodontal disease progressing by:

Allowing Dr. Richards to fold back the gum tissue and remove the disease-causing bacteria before securing the tissue into place. In some cases he may smooth irregular surfaces of the damaged bone to limit areas where disease-causing bacteria can hide and allow the gum tissue to better reattach to healthy bone.
Reducing the depth of your periodontal pockets.
Your oral health will benefit from pocket reduction therapy for the following reasons:

When pocket depths are reduced, you and your hygienist will have better access to the tooth and root surfaces and they can be cleaned more easily.
As your periodontal health improves, any loose teeth will become more firmly anchored in your gums.

If you decide not to have treatment you risk the following:

Inability to keep your tooth and root surfaces clean.
Increased risk for additional bone loss (a 'vicious' circle - deepening of the pockets produces more space for bacterial plaque accumulation).
Your teeth will become looser.
You face an increased risk of developing a gum abcess.
Increased risk of tooth loss.

Crown Lengthening

Crown lengthening is necessary when:

You have a broken or decayed tooth that requires a crown or bridge but the remaining piece of tooth is too short for placement and retention of the new prosthesis.

The treatment requires:

Surgery to increase the amount of undamaged tooth structure necessary to support and retain the crown or bridge. The gum tissue can then establish a healthy seal to the root surface because there now is adequate space for the gum to attach to the tooth (this is referred to as adequate'biologic width').

Crown lengthening will provide you with the following health benefits:

Increase in the length of tooth above the gum line so that a the crown or bridge can be attached and not 'fall off.'

Enables the gum to form a healthy seal around the tooth which will minimise inflammation and prevent bone destruction.

If you choose not to have the treatment you face the following risks:

Inability of your general dentist to install a satisfactory new crown or bridge.

Your periodontal health may be compromised because the width of the gum supporting the tooth is inadequate.

Your crown or bridge may 'fall-off' without warning.

The gum tissue around the crown may become red and inflamed because of inadequate 'biologic width.'

Soft tissue grafts

Soft Tissue Grafts

If you have one of the following dental problems a soft tissue graft may be the optimal treatment:

Long-in-the-tooth appearance due to gum recession.

Tooth sensitivity and pain because of root surface exposure.

Risk of root surface tooth decay.

Inadequate width of firm or sturdy ('keratinised') gum tissue.

The treatment involves:

Surgical repositioning or replacement of soft tissue to establish a protective width of sturdy gum tissue.

A soft tissue graft will provide you with the following health benefits:

A pleasant smile and which will improve your appearance and confidence.

Your teeth will no longer have that long-in-the-tooth look.

The health of your gum tissue will be restored, along with improved resistance to trauma, infection and additional recession.

The root surface will be covered by the tissue graft decreasing the risk of root sensitivity and decay.

Reduce further recession and bone loss

If you decide not to pursue treatment you face the following risks:

Increased long-in-the-tooth appearance as the gum recession continues.

Increased tooth sensitivity and pain.

Less resistance to trauma, tissue damage and infection.

Increased risk of root surface decay.

Periodontal Plastic Surgery

You may require periodontal plastic surgery if:

You have short teeth and a 'gummy' smile which may compromise your appearance.

You have difficulty in maintaining plaque control.

The treatment involves:

Repositioning of the gum line to improve your smile and facial appearance. It may also require reshaping of the bone to establish enough space for the gum tissue to form a healthy protective seal on the root surface.

Your health benefits as a result of this treatment:

Improved appearance and self-esteem.

Ability to prevent infection by allowing you to effectively remove bacterial plaque.

You face the following risks if you decide not to pursue this treatment:

Unsightly appearance and negative self-image.

Ineffective bacterial plaque removal.

Increased risk of periodontal infection.

Bone Regeneration

Bone regeneration is a surgical procedure that may be necessary when

chronic periodontal infection has produced localised bone destruction between and around the roots of one or more of your teeth.

The treatment for bone loss resulting from chronic periodontal disease
re-establishes tooth support through new bone growth. However to prevent recurrence of bone loss from active periodontal disease frequent maintenance and monitoring visits are necessary.

Bone regeneration surgery is beneficial because:

The depth of periodontal pockets around affected teeth will be reduced so that further infection can be controlled.

Increased bone can support formerly loose teeth.

If you allow the problem to persist you face the following risks:

Continued infection because of bacterial growth in periodontal pockets.

Additional bone destruction around the teeth.

Further loosening of the teeth.

Increased risk of gum abcesses and tooth loss.

Ridge Augmentation

You may require ridge augmentation if:

Prior tooth extraction has resulted in excessive bone loss and collapse of the gum tissue into the extraction socket. If a bridge or dental implant tooth is placed in this collapsed area the prosthesis will appear long and unnatural.

Treatment involves:

Using surgical techniques to restore the natural contour in the collapsed extraction site.

Your health benefits as a result of ridge augmentation:

Your replacement tooth has a more natural appearance.

Your risks with no treatment:

Any tooth placed in the extraction site will look long and unnatural.

Your dentist may be unable to create a cosmetically acceptable smile.

Ridge Preservation

You may require ridge preservation surgery if:

You have had a tooth extracted and both the gum tissue and bone has collapsed into the extraction socket.

If a false tooth is placed into the this collapsed area the false tooth will look long and unnatural.

Treatment involves:

Surgery at the time of tooth extraction to prevent or minimise the loss of bone and gum support at the extraction site.

Additional procedures may also be necessary to make sure that the replacement tooth retains a natural appearance.

Your health benefits as a result of ridge preservation:

The replacement tooth or bridge has a more natural appearance.

Your risks with no treatment:

The contour of the extraction site is collapsed. As a result any replacement tooth will be long and unnatural in appearance.

Your dentist is not able to create a cosmetically acceptable smile.

Pocket Reduction Therapy-Osseous Surgery

Pocket reduction therapy may be required if:

Pocket reduction therapy, which includes scaling and root planing for mild periodontitis and osseous surgery for more severe disease, will reduce the risk of your periodontal disease progressing by:

Your oral health will benefit from pocket reduction therapy for the following reasons:

If you decide not to have treatment you risk the following:

Crown Lengthening

Crown lengthening is necessary when:

The treatment requires:

Crown lengthening will provide you with the following health benefits:

If you choose not to have the treatment you face the following risks:

Soft Tissue Grafts

If you have one of the following dental problems a soft tissue graft may be the optimal treatment:

The treatment involves:

A soft tissue graft will provide you with the following health benefits:

If you decide not to pursue treatment you face the following risks:

Periodontal Plastic Surgery

You may require periodontal plastic surgery if:

The treatment involves:

Your health benefits as a result of this treatment:

You face the following risks if you decide not to pursue this treatment:

Bone Regeneration

Bone regeneration is a surgical procedure that may be necessary when

The treatment for bone loss resulting from chronic periodontal disease

Bone regeneration surgery is beneficial because:

If you allow the problem to persist you face the following risks:

Ridge Augmentation

You may require ridge augmentation if:

Treatment involves:

Your health benefits as a result of ridge augmentation:

Your risks with no treatment:

Ridge Preservation

You may require ridge preservation surgery if:

Treatment involves:

Your health benefits as a result of ridge preservation:

Your risks with no treatment: