Pocket Reduction Surgery
This type of surgery is performed if the pocket on the surface of the tooth remains deep despite initial root planing therapy or has not been reduced with previous regular cleanings. The tissue is opened up to expose the affected area, and scalers and hygiene instruments are used to clean the tooth and reshape bone and gum. This reduces the depth of the pocket.
Tissue regeneration surgery is recommended if there is a noticeable deficiency in bone and/or soft tissue on the surface of a tooth. A combination of bone, soft tissue, and/or biologics can be used to stimulate the growth of your own bone and the regrowth and reattachment of the soft tissue, thus reducing pocket depth. The bone used can be either your own, from an area close to the site of the surgery, donated bone, or synthetic bone.
Soft Tissue Grafting
This type of surgery is performed if the tissue around a tooth is thin, detached, and/or missing from the root surface. Tissue is taken from the palate of the mouth, placed and then sutured into the area in need of improvement. A “tissue substitute” can also be used in some circumstances in place of palatal tissue. Soft tissue grafting is designed to create a strong band of healthy tissue to protect the root of the tooth, create bone stability, and help to prevent further recession.
Crown Lengthening Surgery
This type of surgery is required when a filling or crown is to be done for a tooth that has either decay, a crack or fracture that extends below the gumline, and is too close to the bone. The bone and soft tissue are reshaped to fully expose the fracture or cavity.
Esthetic crown lengthening can also be performed if a person has a gummy smile and/or short teeth.
Extraction may be needed if it is determined that the tooth cannot be saved, due to active infection and/or excessive bone loss in the area. The tooth is removed gently while attempting to preserve as much bone as possible. Once the tooth is removed, the site is prepared, by thorough cleaning. In some cases a bone graft will be placed into the cleaned socket. Sometimes a soft tissue graft is also placed. Sutures are then added, along with a dressing. If the tooth is at the front of the mouth, a provisional partial may be recommended. This will be determined at the time of your initial examination.
Sinus lifts are often a first step when dental implants are placed in the back of the upper jaw. When upper back teeth are lost, bone in the area shrinks and the sinuses expand to fill the empty space. The sinus must therefore be lifted to create space for new bone to be placed in the area, in order to place implants of sufficient length.
Implants are sometimes recommended if a tooth is missing. An implant is a titanium post that is placed directly into the surrounding bone, acting as the root of the tooth. The amount of bone in the area must be sufficient to support the implant. Additional bone or soft tissue grafting (Guided Bone Regeneration (GBR) / Guided Tissue Regeneration (GTR)) may be required before the implant can be fitted, but this will be determined at the time of your initial examination. After healing is complete, the crown portion of the implant is placed by your own dentist.
Some periodontal conditions need to be diagnosed by performing a biopsy. This can be required if there are suspicious oral lesions. The biopsy involves the surgical removal of a sample of tissue so that it can be examined in detail by a pathologist.