Most extensive surgery is needed when periodontal disease has destroyed supportive tissue. These procedures reshape or restore lost bone and ligaments. This increases the chance of saving teeth that would likely have been lost. Sometimes, more than one type of procedure is done on the same tooth. These techniques most often require the use of flap surgery to reach diseased tissue.
Bone (Osseous) Surgery
This procedure is used to smooth shallow craters in the bone due to mild or moderate bone loss. First, flap surgery is done to reach the damaged bone. Then your doctor reshapes the bone around the tooth to decrease the craters. This makes it harder for bacteria to collect and grow.
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Supportive bone around the root is diseased and partially destroyed. |
First, plaque and tartar are removed from the infected pocket. |
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The bone is smoothed and reshaped, reducing spaces where bacteria can grow. A substance may be used to help the gum attach to the tooth. |
The gum is then closed over the reshaped bone at or below the original gumline. After the gum has healed, stitches dissolve or are removed. |
Guided Tissue and Bone Regeneration
This helps keep unwanted gum tissue away from the tooth and bone. Ligament fibers can help regrow and bone can reform to better support the tooth.
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After cleaning, a special membrane is inserted between the gum and bone. |
The membrane blocks unwanted tissue, allowing ligament fibers and bone to grow. Once strong ligament fibers attach root to bone, the membrane dissolves or is removed. Stitches are also removed. |
Bone Graft
Tiny fragments of your own bone, synthetic bone, or bone from a bone bank are placed where bone was lost. These grafts serve as a platform for the regrowth of bone. This restores stability to your teeth.
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After cleaning, the graft material is packed into the area where bone has been lost. A special membrane may also be placed between the gum and bone. |
The gum is then closed. The graft may stimulate new bone growth. New bone tissue fills in the crater, providing strong support for the tooth. After healing, stitches dissolve or are removed. |
Soft Tissue Graft
Soft tissue is added to reinforce thin gums or to fill in places where gums have receded. Grafted tissue, most often taken from the roof of your mouth, is stitched in place over the affected area. Stitches dissolve or are removed.
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Thin, recessed gums reveal tooth roots, causing sensitivity and an uneven gumline. |
Thin gums are reinforced with grafted tissue, helping to prevent further recession. In some cases, exposed tooth roots may be covered to improve appearance. |
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