Periodontal surgery is designated to treat patient with pocket depth 6 mm. or deeper.
The objectives of surgery are
1) To gain access to clean up the root surfaces
2) To eradicate the bacteria which the cause of periodontal diseases
3) To reduce the pocket depth
4) To regenerate the new periodontal apparatus.
After the patients finish the initial treatment (SC & RP), the patient will be evaluated for periodontal surgery.
The mouth is devided into 4 quadrants and therefore the maximum is 4 surgeries. One quadrant periodontal
surgery under local anesthesia is approximately 30-45 minutes for Dr. Aubonrutt.
The patient can choose to undergo surgery 1-2 quadrants and in selected cases a full mouth periodontal surgery can be done in single visit depending on the patient's schedule.
We also offer full mouth periodontal surgery under local anesthesia or under general anesthesia
at the affiliated hospital or (Click Fear of Dental Treatment).
Types of Surgery
1) Periodontal Flap Surgery is designed to achieve objective 1-3. It is the most widely
used technique.
2) Osseous Surgery is designed for the disease that cause destruction to the supporting bone.
It is considered a negative treatment since the surgery is involved in removal of the bony wall of the
defect. This technique is popular the 70's and mid 80's. As a result, the patient would have "longer teeth". However, the pocket will be illiminated quite effectively and some of the indications are still applicable at present.
3) Grafting and Regenerative Procedure is designed to regenerate the periodontal tissue that has been destroyed by the disease. Therefore, it is considered a positive treatment. However, the
result of regeneration is sensitive to a number of factors and limited to a few milimeters.
New research is directed to delvelop new materials and techniques to facilitate tissue engineering.
However, the cost of the new materials used in the regenerative procedures are sometimes cumbersome.
These techniques are used in the area that the gum has recessed to increase the keratinize tissue
(thick & non-mobile gum) on the root surface.
The picture illustrates the FGG on a dental implant.
The new gingival grafting material "Mucograft" is now available in our clinic to
reduce the morbidity of the donor site.
BoneGraft
1) Autograft The patient's bone are taken from other sites in or outside of the mouth and place into the periodontal defect. 2) Allograft Processed Human bone from the accredited tissue banks, available in various forms and shapes. 3) Xenograft Processed Bovine Bone.
Guided Tissue Regeneration : The relatively new technique utilizing resorbable or non-resorbable membrane to regenerate the soft and hard tissue that has been destroyed by the periodontal disease.
4) Combined Surgery In a severe case, there may be more than one type of defects in a
quadrant. Therefore, a combination of surgical techniques 1-3 can be applied in a surgery.
We offer full lines of regenerative materials both resolvable and non-resolvable membranes are available. For the patient's convenience bone graft from the tissue banks which are accredited by the American Association of Tissue Bank are available in many forms and shapes.
The new tissue engineering technique and materials are also available.
