Under local anesthesia, the roots of the teeth are cleaned from the bacteria and harmful deposits build up. 3D bacteria formation are so well organized and protected by a biofilm, that antibiotics should be taken in a 1000 x stronger dosage concentration in order to be effective!
Pockets are cleaned with a combination of surgical and so called sonic (sound) instruments. Sonic instruments are more pleasant and “gentle” than ultrasonic, enabling the surface of the root to remain smooth.
With the elimination of deposits the deterioration of tissue is stopped, and the pocket depth reduced. In shallow pockets, conditions for the growth of bacteria are not that good, improving overall periodontal health.
Surgical periodontal therapy
After the scaling (“curettage”) procedure, if some pockets remain deep (more than 5-6 mm) and continue to bleed, surgical therapy is recommended. It is a procedure performed on individual teeth. Times when the entire jaw was operated are behind us.
It is possible to recreate the supporting tissue of the bone for crater bone defects with regenerative surgery techniques.
If continuous infection is caused by the fact that deposits have not been completely removed from the root with scaling (cleaning of the pocket without visual control), a micro access flap is recommended.
If the anatomy of the surrounding tissue requires reshaping (i.e. of the fibrous growth of the palate tissue or bony outgrowth near the edge of the tooth), a pocket removal surgery is performed.
In the Dental Clinic Rident all periodontal surgery interventions are performed using minimally invasive techniques. Postoperative hardships are minimized, with optimal results.
Today it is possible to perform a regeneration of bone defects. The periodontal disease is characterized by the deterioration of the supporting tooth bone, which can be uniform, or with craters present. Bone defects in the shape of craters can get regenerated.
After a thorough cleaning of the tooth root, the defect is filled with biologically active substances that boost the regeneration of the attached tissue (bone and cement). This kind of surgery has good results only when dealing with certain anatomy defects, and requires more frequent visits immediately before and after the surgery.
The root of the tooth is accessed with micro surgical instruments so that the area that needs to be cleaned is visible to the eye. A significant reduction in number of the bacteria, removal of deposits and root scaling contribute to the elimination of gingivitis and deep pockets.
Surgical removal of pockets
A bone weakened by a periodontal disease is irregular. The dents that occur are recesses ideal for the creation and growth of bacteria. The aim of surgery in these cases is to remove imperfections, smooth the bone structure and shape the gums.
With healthy teeth or those affected by periodontal disease the mouth cavity is full of bacteria. Patients that suffer from periodontal diseases have a genetic tendency to an infectious overreaction to bacteria. Even if it would be theoretically possible to eliminate all bacteria, very soon a re-colonization would take place as well as a consequential inflammatory reaction. This means, that there is no successful one-time treatment for periodontal disease, although some dental office Internet pages claim otherwise. A periodontal disease is a chronic infection that needs to be controlled throughout ones life and when needed interventions should be made.
After placing dental implants for patients with periodontal disease, a maintenance therapy is of the utmost importance.
The frequency of control visits depends on the degree of the disease as well as on the patient’s oral hygiene, and is thus determined individually (usually 2-4 times a year).
Covering bare tooth necks (gingival recession)
There are several possible causes for bare tooth necks, and for the most part they refer to inadequate brushing techniques.
With cosmetic surgery techniques, bare tooth necks can get covered, solving aesthetic problems, teeth oversensitivity, further advancement of receding gums, and tooth neck caries.
In our Clinic we apply highly advanced, sophisticated techniques of minimally invasive procedures to cover recessions.
In order to establish long term stability of achieved results, we instruct patients to use appropriate means and tooth brushing techniques.
Cosmetic gum surgery
The perception of beauty is individual; it changes through culture and time and is subject to fashion, and, especially nowadays, to the influence of media. A wide smile that shows many white teeth and healthy gums is the focal image of our time.
Red, swollen gums, long, bare tooth necks, jaw defects following teeth loss – give way to an unpleasant smile.
Today, most of these imperfections can be removed or reduced with cosmetic gum surgery.
Behind the creation of a beautiful smile stands a team. A prosthetic, technician, parodontologist, surgeon and orthodontist equally participate in the planning and treatment procedures.
In our Clinic we have ideal conditions – doctors of all specializations and highly educated technicians send out the message: “Your smile is our concern.”
Surgical lengthening of tooth crown
a) surgical lengthening of tooth crown for aesthetic reasons
b) surgical lengthening of tooth crown for functional reasons
If caries or tooth fracture is found deep under the dental gum, our Clinic has a solution at hand. The edges of the crown or filling can’t get accurately shaped; rousing the tissue that leads to inflammation and bone recession. This can be prevented with a simple surgical lengthening of the crown.
The gum and bone are accurately surgically reduced and shaped, making healthy teeth edges clearly visible and well accessible to the dentist.
A pre-prosthetic surgery is a procedure that prepares the soft and hard tissue of the mouth cavity for a better functional and aesthetic prosthetic rehabilitation. It starts with the protection of tooth structures during the surgical procedure of extracting the tooth:
- Measures of jaw volume protection after tooth extraction
- Surgical lengthening of tooth crown
- Thickening and expanding fixed gums
- Covering the recession (of bare tooth necks)
- Preparing the tissue for the placement of implants
Conventional or surgical curettage solves many problems: removes the infection, reconstructs the bone and treats the tooth.
In a healthy jawbone the root of the tooth is completely “anchored” to the bone and connected to it with supporting fibers (the periodontium). There is a difference between the inflammation of the gum tissue (gingivitis), and the inflammation of the entire supporting and surrounding teeth tissue (periodontitis). Gingivitis is characterized by swollen, intensively red gums, that tend to bleed. It is easily treated with professional teeth cleaning in the dental medicine doctor’s office and optimal daily teeth care.
An unattended gingivitis can progress to periodontitis. Because of the inflammation, gums swell and separate from the teeth surface. This leads to the creation of pockets that favor the growth and propagation of bacteria. The surrounding tissue reacts to bacteria and their harmful products with an inflammation.
The consequence of an inflammation is the disintegration of the supporting tooth tissue including also the bone. Often, the progress of periodontal disease is weak in symptoms. With time, however, the inflammatory osseodisintegration may lead to loosen teeth as well as loss of teeth.
Today, however, dental implants can replace missing teeth. Nevertheless, if the bone is damaged because of inflammation processes, dental implants can be placed after or simultaneously with the reconstruction of the bone.
What are the symptoms of periodontal disease
- Bleeding gums
- Swollen gums, redness and pain
- Gum recession
- Pocket discharge or pus
- Alteration in teeth position, deepened areas between teeth (abscesses)
- Loose teeth
- Teeth loss
But → the occurrence and the progress of the disease are often weak in symptoms!
I don’t have a periodontal disease, or do I?
The majority of people that have a periodontal disease are not aware of it or of the fact that there exists such thing as a periodontologist. Often, a periodontal disease remains unnoticed due to a chronic progress weak in symptoms.
How to diagnose a periodontal disease?
For a rough orientation a Periodontal Screening Index (PSI) is conducted. The examination takes 2-3 minutes and is harmless.
If a gingival or periodontal disease is determined, a total periodontal exam is recommended, professional teeth cleaning or a specific periodontal therapy.
Total periodontal exam and plan of therapy
Pockets are checked on 4-6 locations around every tooth, gums recession is recorded, as well as the degree of tooth movement and coverage of the root bifurcation.
An X-ray diagnosis is mandatory.