Periodontal surgery: causes and recovery process

Periodontal surgery is a surgical technique used to treat areas affected by pyorrhea or periodontal disease. This disorder is the chronic infection of the supporting tissues of the teeth: the gums, the ligament and the bone.

Periodontal surgery is used when basic initial treatments have not been sufficient to eliminate the disease. It consists of a minimally invasive procedure in which the gum is detached from the teeth and the bone that is underneath.

It is possible to generate a direct space to clean the roots of the teeth, decontaminate, reshape the gums, regenerate the tissue and thus put an end to the ailment.

Read on to learn more about this surgical procedure, when it is necessary, and why it is performed. Also, what care must be taken for a successful recovery.

Why is periodontal surgery performed?

As it was mentioned already, periodontal surgery is used only as a complementary therapy to the basic initial treatment. When this has been done, the results are evaluated and, if the disease still persists, its usefulness can be considered.

Through periodontal surgery the dentist can decontaminate the area, scrape and smooth the roots of the teeth and remove the infected pockets. In addition, it rebuilds or replaces damaged tissues through gum transplantation or grafts of materials similar to bone.

Thus, this procedure treats people with severe or very advanced periodontal disease who do not respond to basic treatment.

What are the objectives of periodontal surgery?

When periodontal surgery is performed, the elimination of the disease and the recovery of the affected supporting tissues are sought. During the procedure, the dentist pursues the following objectives:

• Eliminate inflammation: removing the damaged tissue and the factors that originate the problem, such as bacterial plaque, tartar and bone imperfections.
• Control the infection: It is intended to eliminate the bacteria that proliferate under the gums and create an environment that favors the control of bacterial plaque.

• Reshape and regenerate lost support tissues: to restore the protective function to the periodontium and restore aesthetics in the patient's smile.

Types of periodontal surgeries

The treatment of periodontal disease seeks to restore lost health to the supporting tissues of the teeth. For its approach, the dentist must identify and treat the systemic and local factors that may be causing or increasing the risk.

What's more, the professional will carry out the initial and basic measurements in the office. This consists of removing the bacterial plaque and tartar that is found above and below the gums. It is done through scraping and smoothing the roots.

The success of this first stage depends a lot on the incorporation of hygiene habits into the patient's oral care routine. Monitoring and evaluation of this non-surgical treatment will determine how to proceed.

There are cases in which periodontal surgery is necessary to resolve the situation and complete the treatment. The most common procedures are detailed below.

Resective or access surgery

Performed to comfortably and precisely access the roots and the supporting bone of the teeth. This is for the purpose of cleaning and treating. Also, try to eliminate or reduce gum tissue pockets.

The technique consists in the realization of a minimally invasive flap that tries to preserve the dental papillae and the healthy support structures. Currently, the use of microsurgical instruments and magnification allow precise approaches.

Regenerative surgery

This type of periodontal surgery is used to increase the level of lost bone and thus favor the insertion of the tooth. It is useful in those cases of very advanced disease, when bone loss is notable and tooth mobility is already evident.

With a minimal gingival recession, an attempt is made to eliminate the depth of the pocket and replace the lost tissue through grafts or biomaterials. Depending on the case, one or more of the following fillers are used:

• Autografts: using tissue taken from another sector of the same patient.
• Allografts: they are grafts of the same species obtained from tissue banks.
• Xenografts: the fabrics are of animal or synthetic origin.
• Biomaterials: as growth factors or porcine amelogenins.

The placement of these materials allows to increase the support of the teeth, improving the prognosis and the permanence of the pieces in the mouth. New microsurgical techniques and the use of magnification also contribute to more precise and less invasive procedures.

Postoperative care of the patient in this surgery is vital. The use of tobacco is contraindicated. The control of the bacterial plaque must be very exhaustive and the controls are essential.

Mucogingival or periodontal plastic surgery

Prevents or corrects gum and alveolar bone defects due to anatomical or developmental alterations or caused by trauma or disease. It includes crown lengthening, root coverings, gingival augmentations and correction of mucosal defects around the implants.

It may interest you: Crown lengthening: what does it consist of and what are its risks?

How to prepare for periodontal surgery?

Before undergoing periodontal surgery, the dentist in charge of the procedure will indicate some prior care. The use of alcohol and tobacco should be avoided from 24 hours before to the intervention.

The use of the patient's usual medication should be taken into account. Anticoagulants or antiplatelet agents may need to be stopped. Additionally, antibiotics prior to the procedure may be necessary to decrease the risk of infection.

It is useful to have someone in charge of accompanying the patient after surgery and take you home when the procedure is finished. Due to the use of anesthesia and sedation, it is not certain that the person who was operated on will drive.

How is the recovery process?

Recovery will depend on the intervention performed, the severity of the previous illness, the general health of the patient, and the postoperative care. It is important to comply with the indications recommended by the professional to avoid complications.

After surgery, the presence of discomfort in the area and slight bleeding is to be expected. The tips that help a speedy recovery are the following:

• Do not use mouthwashes: Swallowing, rinsing, and spitting should be avoided on the day of surgery, as these movements increase the risk of bleeding.
• Place cold in the area: Intermittently using ice or cold compresses reduces swelling and discomfort.
• Not resuming normal activities one day after the procedure: physical activity, sudden movements and efforts should be avoided.
• Avoid using tobacco: Smoking interferes with the healing process and increases the risk of complications.
• Maintain oral hygiene: The toothbrush should not be used in the intervened area for a while. But you should control the plaque in the rest of the mouth with a gentle and slow brushing. The dentist may recommend the use of special mouthwashes from the second day after surgery.

• Soft and cold diet: cold foods help healing and soft foods have less impact on the intervened area. Ice creams, puddings, yogurts, jellies, and purees are a good option.
• Take the indicated medication: the use of anti-inflammatories, analgesics and in some cases antibiotics indicated by the professional are necessary for an adequate recovery.

Also read: 8 cares for after tooth extraction

Visit the dentist frequently

The health of the tissues that support the teeth is not only important for the proper functioning of the mouth. It also reduces the risk of other systemic diseases associated with periodontal disease.

Maintaining proper oral hygiene and frequent visits to the dentist is the key for a healthy mouth. In any case, if for any reason you suffer from severe pyorrhea, periodontal surgery is an effective option to restore health to the support of the teeth.