Surgical treatment of periodontitis
The marginal periodontal is the aggregate of the supporting structures of the tooth: gingiva, bone, ligament, the root of the tooth. Each tooth in the jaw is located in the holes – alveoli. The tooth in the bone is supported by the periodontal ligament, which is located in the periodontal gap, between the tooth and the bone. One end of periodontal ligament penetrates into the outer layer of the tooth root – cement, and another one – into the bone surrounding the tooth. The tooth is surrounded by the gingiva.
The causes of marginal periodontal disease are microorganisms present in plaque. Unremoved soft dental plaque eventually mineralizes and becomes dental stones and facilitates the accumulation of soft plaque.
Chronic periodontal inflammation develops without timely high-quality cleaning of dental plaque, in case of an impaired immune response and general diseases.
Prolonged periodontal inflammation leads to the breakdown of the periodontal ligament, the formation of pathological periodontal pockets, loss of alveolar bone, tooth mobility, gingival recession. Due to the recession of the epithelium toward the root apex, the resulting periodontal pockets are a favourable medium for microorganisms that cause periodontal diseases.
The essence, objective, and method of surgical treatment
Surgical treatment of periodontal is performed to stop or slow the progression of periodontal disease, to restore lost peripheral periodontal tissues, and to maintain the results of periodontal disease treatment. Surgical treatment is only applied if deep periodontal pockets and bleeding after probing still persist after a professional oral hygiene procedure.
The main objective of periodontal surgery is to eliminate periodontal pockets. In this way, the medium favourable for microorganisms causing periodontal diseases is removed and the progression of the periodontal disease is stopped. Other tasks of periodontal surgery include removing or reducing damage to marginal periodontal, restoring function and form of periodontal tissues, creating favourable conditions for individual oral hygiene, maintaining aesthetic mouth, and preparing teeth for restorative treatment.
Usually, local anaesthesia is sufficient enough for the surgical treatment of periodontitis.
During the operation, the assessment of the depth of periodontal pockets is performed, dental surfaces are cleaned (removal of concretions, granulations, levelling of root surfaces), bone defects are eliminated and alveolar bone plastics are performed.
Without the periodontal surgical procedures in cases of severe periodontal disease does not ensure the prevention of the decay of periodontal tissue and the elimination of inflammatory foci. This eventually leads to progressive breakdown of the periodontal ligament, the formation of deepening periodontal pockets, resorption of increased alveolar bone, increased tooth mobility, and suppuration from periodontal pockets. For these reasons, the teeth are being lost, they needed to be removed and their loss has to be restored by means of dental prostheses and/or implants. Progressive inflammatory phenomena in the marginal periodontal result in the decrease of the body resistance, overall body health, development and progression of chronic diseases such as diabetes, atherosclerosis, rheumatoid arthritis, etc.
Plastics of lips and tongue frenulum
The tongue frenulum is the usual anatomical structure, which is like a link going from the bottom of the tongue and attaching to the soft tissue of the bottom of the mouth.
A short tongue frenulum is a developmental problem when the tongue is sort of attached to the bottom of the mouth. A short tongue frenulum prevents the full tongue from sticking out and lifting the end of the tongue, so when a child starts speaking, it may be difficult for him to pronounce some sounds (usually R, L, Š, Ž, Č). In the older age, a short tongue frenulum can cause problems with the gingiva and occlusion. Surgical treatment of short lip frenulum is performed in 11-12 years.
The central frenulum of the upper lip is attached between the front teeth in the upper jaw. Short lip frenulum usually affects the appearance of a space between the front teeth.
Treatment of gingival recession
Gingival recession is a gingival retreat from the tooth. In the case of a gingival recession, the tooth neck or part of the tooth root is uncovered. The tooth looks longer, it is sensitive, the aesthetics of the smile decreases. The recession is treated surgically through gingival plastics when the recession area is being covered by a free autotransplant from a palate or synthetic gum substitutes.
Gingivectomy
Gingivectomy is surgery when an excess of gums are removed; it is often applied to lengthen the length of the tooth crown. Gum contour is changed during the surgery. After prolongation of the tooth crown, a higher quality dental prosthesis when the tooth crown enshrouds more healthy hard tissues of the tooth is possible.
Post-surgery recommendations
- After surgery, bleeding may occur for about 30 minutes. For the first day, the colour of saliva due to small bleeding may be pink.
- After surgery, swelling of the tissues is possible, which is usually the highest on the third day after which it recedes. It is necessary to use anti-inflammatory medications prescribed by a doctor for the reduction swelling for 3to 5 days, and immediately after the surgery, it is recommended to keep an ice blister on the cheek in the operated area for 20-30 minutes.
- The painkillers prescribed by your doctor should be used.
- It is recommended not to eat about 2 hours after the surgery. On the first day, hot, hard, spicy food should be avoided; not to chew with the operated side. It is recommended to eat soft, warm food and drink cool liquids.
- The operated area must not be warmed.
- It is recommended not to clean your teeth for the first day after the surgery, then to brush your teeth twice a day with a soft brush, except for the operated area. One week after the operation, the operated area should be cleaned with a special, very soft, post-operative brush applying gentle sweeping movements.
- Do not rinse your mouth on the first day after the operation, and then rinsing your mouth is possible with the prescribed antiseptic solutions twice a day after brushing your teeth.
- Not to smoke at least 24 hours is recommended after surgery.
- If a special postoperative bandage has been applied, it should not be touched. The doctor will remove the bandage and stitches after a week.