Gingival bandage after curettage. What are the consequences of pathology? Video about open curettage

Hello dear visitors. We welcome you to the pages of our site. Today we will talk with you about such a procedure as gum curettage. We will discuss the purpose, methods of implementation, contraindications, as well as modern technologies as an alternative to this technique.

What is curettage and how does it happen?

If the patient suffers from periodontitis, the doctor performs cleaning of teeth, roots, periodontal pockets. This procedure is called curettage. In the process, not only plaque and, but also diseased tissues are removed along with pathogenic organisms / waste products of bacteria.

A periodontal pocket is a groove, a depression that forms between the gum and the cervical part of the tooth crown. At healthy person the recess does not exceed 3 mm. With a depth of 4 mm or more we are talking about various diseases gums Deep pockets are caused by plaque and calculus. The latter has the properties to form even on the subgingival part of the tooth and the root.

The greater the number of such deposits, the more dangerous the bacterial process. Harmful microorganisms cause inflammation of the gums. Over time, the volume of bone tissue decreases, the tooth is exposed,.

If an operation is planned for the near future, it will not be possible to avoid the procedure. Eliminate all sources of infection before surgical intervention. Otherwise, there is a high risk that the operation will be in vain, the inflammatory process cannot be stopped.

If the depth of the periodontal pocket does not exceed 4 mm, closed curettage is performed. In this case, a gum incision is not required. When the pocket has a depth of 5 mm, the doctor resorts to open curettage.

Open gum curettage

Open type of curettage - full-scale surgery, during which the following actions are performed:

• the flap is removed from the gums. This procedure uses local anesthesia;
• removal of subgingival calculus damaged by tissue granulation, etc.;
• the gum pocket is treated with an antiseptic;
• are used special means replacing bone tissue.

Open curettage - stages

At the end of the procedure, the gum is sutured. If the amount of removed damaged tissue is too large, a small fragment from the sky is used for replacement. For similar bone problems, bone grafting is necessary.

Video - Open curettage

To perform this procedure, special tools are used. They can be either manual metal or ultrasonic. First of all, the doctor needs to determine the depth of the periodontal pocket. For this, special probes are usually used. Next, the pockets are cleaned, washed with antiseptic preparations. Hard and soft deposits are removed, the roots are polished.

After such a procedure, smaller pockets disappear, and deep pockets - more than 4-5 mm - become smaller. Also, the gums stop itching and bleeding, their soreness decreases. In addition, this good way protection of teeth from mobility.

A side effect of the procedure is a temporary increase. They begin to react to hot and cold foods/drinks, sweet and sour foods.

Video - Closed curettage

Contraindications for gum curettage

There are situations in which doctors usually do not perform curettage. Among them:

• tooth mobility grade 3 and above;
• bone;
• too thin gums, fibrosis of periodontal tissues;
• inflammatory processes occurring in an acute form.

Before prescribing any operation / procedure, the doctor weighs all the pros and cons. After all, the dentist must comply with the principle of "do no harm", like any other physician.

Alternative Methods

Now some clinics offer to perform periodontitis treatment without curettage. Instead of the usual procedure, they offer another one, using the Vector apparatus. It should be clarified that these are not interchangeable methods. In particular, if it is necessary to build up bone tissue, without patchwork operation the use of bone-replacing materials and membranes is indispensable. But the inflammation mentioned apparatus can be effectively eliminated.

In some cases, the techniques are good in conjunction. First, with the help of "Vector" soft tissues are processed. Then, using classic curettage, the doctor will treat the root, remove granulations. But not vice versa, because after curettage, the periodontal junction is closed with an insulating bandage and probing of this area is prohibited.

The next procedure can be performed no earlier than a month later.

After curettage

After the anesthesia wears off, the gums may ache. How much depends on the type of operation and pain threshold specific person. If you can hardly endure pain, do not suffer. Ask your doctor to prescribe pain medication for you while you recover. The procedure is not the most traumatic of those existing in surgical dentistry. However, in order to avoid subsequent inflammation, severe pain and others unpleasant consequences you need to follow certain guidelines.

1. The first few days after the procedure, you should eat only liquid and soft foods. Otherwise, you risk damaging unrecovered gum tissue and getting inflammation.
2. For the same reason, it is worth replacing the standard brush with a similar one with a soft bristle type (soft). Then the risk of injuring the gum is much lower.
3. Avoid hot drinks/food and alcohol.
4. Use antiseptic rinses after meals. Number of bacteria in oral cavity significantly reduced by such a simple procedure.

Some patients, thinking that it is better not to touch the gum, stop brushing their teeth altogether after the operation. This is a big misconception. After all, without performing hygiene procedures, you create the same conditions that led to periodontal tissue disease.

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Preventive measures

So that you do not have to go through the gum curettage procedure, do not forget about regular oral hygiene, that is, pay special attention to removing all deposits that have accumulated on the surface of the teeth. In addition, it is recommended to additionally use floss (dental floss) and an irrigator. Visit the dentist's office regularly preventive purposes(at least twice a year) in order to be able to identify and cure a particular disease in a timely manner.

If available, it is necessary to resort to a professional teeth cleaning service - this way you can prevent the subsequent development pathological process. Special attention pay also proper diet nutrition - it should be saturated with useful minerals and vitamins. Follow all these conditions so that your teeth are strong and healthy!

Any gum disease is a very long and unpleasant process. Increasingly, patients with similar problems as gingivitis, or a more complex form, turn to dental clinics. inflammatory disease- periodontitis.

With the seeming harmlessness of such diseases at the beginning, they can lead to serious problems up to the loss of teeth.

That is why in dental practice one of the most effective methods Treatment of gum disease is curettage of periodontal pockets. About what methods for carrying out this procedure modern surgical dentistry, and how they differ, will be discussed in this article.

general information

Treatment of periodontitis involves whole complex aimed at eliminating the cause and the possibility of recurrence of procedures. If the disease is mild or moderate, then curettage will be part of this complex.

At its core curettage is the cleaning of periodontal pockets that form between the gum and the tooth. Sometimes it is also called in a different way - dental, periodontal, gum pocket.

If its dimensions exceed 3 mm, then cleaning by conventional methods is ineffective. Therefore, surgical

Formation of periodontal pockets

In order to understand this, it is necessary to know and general information about the course of periodontitis.

• One of the factors in its development is insufficient hygiene oral cavity, which allows the formation a large number deposits different kind on the surface of the tooth.
• Inflammation in the gums is triggered by microorganisms contained in plaque.
• The mineralization of plaque leads to the formation of extremely hard deposits, which are called tartar, and it, in turn, tightly attached to the enamel, produces pathogens and toxins as a process of their vital activity.
• The onset of inflammation provokes changes in the bone tissue - its atrophy and resorption.
• The granulation tissue that appears at the site of resorption further accelerates the process of bone destruction.
• Gradually, a cavity forms in place of the destroyed bone tissue. There is no normal attachment of the gums to the teeth and there are many deposits and granules.

The need for

The need for this operation is explained, first of all, by the fact that the process of atrophy, destruction and replacement of healthy tissues with granulate becomes almost irreversible when gum pockets form.

Anti-inflammatory and local therapy, together with superficial cleaning and antibiotics, have only a short-term effect.

• First of all, acting by conventional methods, the doctor does not have the opportunity to completely clean the cavity, since he acts almost blindly. The granulate and bacteria that remain inside provoke further development diseases.
• In addition, even if it is possible to clean all the deposits, the periodontal pocket does not disappear. It is in it that the ideal conditions for the resumption of infection and the progress of the disease are found.

Therefore, a method is needed, which is curettage, which allows you to immediately eliminate the entire list of problems:

• Deposits on the surface of the tooth and those hidden by the gums.
• Granulation tissue formed as a substitute for bone tissue.
• periodontal pockets.

There are several methods of surgical intervention pursuing the same goal. It is the elimination of altered and diseased tissues to eliminate disease-causing factors. They differ from each other only in the degree of intervention and the way the operation is performed.

closed type operation

If the patient is found easy stage periodontitis, when the depth of the pockets is small - about 3-4 mm, then the first type of closed-type curettage is quite often used.

Its purpose is to remove granules, deposits under the gum, affected cementum of the tooth root, decomposed tissues and particles.

The main feature of the technique is that the manipulations are carried out by the dentist blindly, without excision of the gums and full access to the affected cavity. The lack of visualization requires the surgeon to be extremely meticulous, with great patience and professional skills. Indeed, in addition to removing altered diseased tissues, healthy ones cannot be damaged.

Indications

It is necessary for mild and moderate varieties of the underlying disease. In this case, the depth of the cavity should not be more than 4 mm, otherwise there will be no expected efficiency. Also, the presence of so-called bone pockets, and the gum tissue itself should be of normal density.

Contraindications

Like all surgical procedures, closed curettage also has contraindications.

• The depth of the pocket is more than 4.5 mm.
• Presence of an abscess or suspicion of its presence.
• The appearance of bone pockets.
• Purulent discharge from the cavity.
• thinning or fibrotic changes gum tissue.
• 3rd degree of tooth mobility.
• Separate infectious diseases oral cavity.
• Some common diseases.

Methodology

There are several mandatory stages of the operation, the sequence of which must be observed.

It will be possible to judge the effectiveness of the operation performed only after the time sufficient for the formation of scar-connective tissue has elapsed. This usually takes about 2-3 weeks.

The disadvantage of this technique is that without the filigree accuracy, which only experienced professionals possess, healthy tissues can be damaged. This sometimes leads to complications in the form of pulpitis, prolonged bleeding, suppuration.

Vacuum curettage

One of the types of operation. Here the curettes are connected to the apparatus to create a vacuum. The main advantage of the technique is that pathological tissues not just scraped off, but immediately removed from the cavity. This contributes to a significant reduction in the occurrence of various complications.

How closed curettage of periodontal pockets is carried out - see the following video:

open type operation

The purpose of the operation is the same actions as in the case of closed curettage. But, unlike him, the periodontal pocket itself is also removed here, as a likely source of bacteria and a factor in possible recurrence.

Indications

• The depth of the pocket cavity is more than 5 mm.
• Strong growth of granulation tissue.
• Change in the shape of the interdental papillae.
• Detachment of the gum margin from the surface of the teeth.

Contraindications

• Possible necrotic processes in the gum tissue.
• Too strong its thinning.
• Abscess.
• The appearance of pus in the surrounding tissues and the cavity itself.
• Various infectious dental diseases.

Methodology

As in private method, there are certain stages of the operation.

• Antiseptic treatment of the entire oral cavity, anesthesia.
• Making an incision along the tops of the interdental gingival papillae.
• Flaking of the inner and outer gums, as well as mucosal flap to a sufficient depth (no more than the depth of the formed cavity).
• Complete removal of all deposits and diseased tissues with visual control by a doctor. The tools used at this stage are scalers, hoes, curettes.
• Polishing of all surfaces of the tooth and its roots.
• Excision of altered and diseased periodontal tissues.
• Removal of granulate and epithelium that has grown into the pocket.
• antiseptic treatment. Laying the papillae with their subsequent fixation with a surgical suture. Applying a protective bandage with anti-inflammatory drugs.

How is it carried out open curettage periodontal pockets - see the following video:

Prices

The cost of both methods will be different and it does not depend on the clinic. The fact is that open curettage is not only the most effective in complex forms of the disease, but also requires great effort from the doctor.

The average cost of a closed operation for one tooth is about 800-1000 rubles, and an open one is about one and a half to two times higher - up to 1700 rubles.

This amount includes anesthesia, treatment with various drugs, the actual work. Depending on the complexity of the operation, the price may be higher, but without an examination, the doctor is unlikely to be able to give an exact cost.

Also, prices may vary slightly depending on the region and clinic. Popular large dental centers having a name and inviting only experienced professionals, may request 30-40% more for the same operations.

What are the patients saying?

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In the presence of periodontal pockets with a depth of more than 3-4 mm and granulation tissue therapeutic treatment won't be enough. Neither taking antibiotics nor removing dental plaque will help.

Removal of dental deposits is completely impossible, and part of them remaining after cleaning continues to destroy tissues. If the pockets are already deep enough, then the infection in them will continue to develop.

Thus, for the treatment of periodontitis, it will be necessary to apply surgical methods that will allow:

• Remove deposits in the subgingival area.
• Remove granulation tissue.
• Eliminate periodontal pockets.

Surgical methods for the treatment of periodontitis

These include:

1. Curettage of periodontal pockets.
2. Flap operations.

Depending on the depth of periodontal pockets, one of the methods of curettage is used, open or closed.

Closed way effective on mild stage diseases. The procedure includes cleaning of periodontal pockets and polishing of tooth roots - without compromising the integrity of the gums. First, subgingival tartar is removed, then the bottom of the pocket is treated. With a special tool, granulations are scraped from its walls and bottom. Upon completion, the periodontal pocket is irrigated with a stream of warm isotonic solution sodium chloride.

The whole procedure is carried out under local anesthesia. According to the doctor's indications, a protective bandage of repin, stomalgin or zincoplast is applied. Eating is possible only 3-4 hours after the operation. In this case, dental instruments are used: metal manual or ultrasonic.

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Advantages of closed curettage

• The procedure takes little time.
• It is easily tolerated by the patient.
• Does not require high qualifications from a doctor.
• It has a relatively low price.

However, closed curettage also has disadvantages:

• The procedure is performed blindly: the surface of the roots and periodontal valves are not visible.
• It is effective only in the first stage of periodontitis.

Using this method, it is possible to remove granulations and dental deposits in the gum area from periodontal pockets, reduce the size of deep pockets and nullify shallow ones. With advanced forms of periodontitis, this will be a temporary measure. The mass of granulations will decrease, the condition of the gums will improve, but the disease will develop further.

A month after the procedure, the specialist should conduct an examination: with a depth of periodontal pockets of more than 5 mm, the patient is assigned an open curettage.

It is carried out in order to remove periodontal pockets, granulation and excess subgingival dental deposits, to “replant” synthetic bone, thereby restoring the missing bone tissue. A segment of 7-8 teeth is processed at a time.

Cleaning of teeth from deposits, anti-inflammatory therapy and splinting of groups of teeth is necessary in advance.

The course of the open curettage procedure

First, the gingival mucosa is peeled off from the teeth and bone. To do this, make an incision around the neck of the operated teeth. As a result, the surface of the roots is exposed and bone defects, dental deposits and periodontal bone pockets become visible.

Special surgical curettes and ultrasound remove granulation tissue and tartar. Bone tissue, the roots of the teeth are treated with an antiseptic and only after that the synthetic bone is “planted”. At the end, sutures are applied to the area of ​​the interdental papillae, and finally, a gingival bandage is applied to protect the operated area.

The entire procedure is performed under local anesthesia. The sutures are removed after 10 days.

Advantages of open curettage

The procedure allows you to stabilize periodontitis, eliminate periodontal pockets, correct bone tissue atrophy and reduce tooth mobility.

Cons of open curettage

• Should be performed by a highly qualified surgeon who specializes in periodontics.
• High price operations, expensive consumables.
• In the process of granulation tissue, exposure of the roots of the tooth may occur.
• The appearance of the gingival papilla changes, but after a few months they take their former shape.
• The procedure takes a lot of time (it takes about 2 hours for a segment of 7-8 teeth).

Within a few days after the curettage, the operated area should not be brushed with a toothbrush. Teeth are cleaned by rubbing them cotton swab dipped in weak antiseptic solution. The oral cavity should be frequently rinsed with antiseptics. Probing of periodontal pockets should not be carried out for about 3 more weeks.

By contacting our clinic for the treatment of periodontitis, you will receive all the necessary services, including an initial examination and consultation with a therapist. The specialist will give you recommendations based on the examination of the oral cavity and data x-ray. Depending on the stage of the disease, we will offer open or closed curettage and carefully prepare the oral cavity. At the end of the procedure, the surgeon will apply a protective bandage.

We have surgeons who specialize in periodontics. In practice, they honed their skills in working with a laser, mastered bone grafting, open and closed curettage. We will be happy to offer you this complex procedure at a really low price compared to other clinics in Moscow. Additional discounts and special offers developed by us will reduce the cost of treatment, but will not affect the high quality of our medical services.

Some dental patients are faced with a procedure such as open or closed curettage of periodontal pockets. We will talk about what it is, prices and reviews below in more detail. After all, the patient needs to know what he is going for and what to prepare mentally for.

It should be understood that any inflammatory processes in the tissues cannot be cured without high-quality cleaning and treatment of subgingival deposits. And do it with ultrasound procedure not always possible. Therefore, doctors have to resort to more complex and painful manipulations for the qualitative and complete elimination of foci of infection.

Characteristics of the periodontal pocket

In medicine, this phrase refers to a small natural gap between the neck of the tooth and the gum that covers it. Normally, it should not be open and deep. So, if the size of the periodontal pocket does not exceed 0.15 mm, then clean them from various deposits can be achieved with regular sonication.

In other cases, food debris, plaque, tartar, bacteria accumulate more and more intensively and lead to inflammatory processes, thereby expanding the gap between the gum and the tooth and aggravating clinical picture. This phenomenon can be observed both on one jaw, and immediately on both.

Doctors believe that even the formation of a periodontal pocket of 3 mm or more is already one of the symptoms of tissue pathology. And if not done timely treatment on the early stages, then this will lead to chronic, which is much more difficult to get rid of.

Symptoms

The formation of plaque, deposits, bacterial growth and deepening of the pockets are at first imperceptible. And only with the appearance serious complications the patient notices signs of inflammation:

• discomfort in the gums;
• close people complain about during a conversation, even if hygiene procedures were performed before;
• redness, swelling forms on the mucous membrane, its surface becomes shiny;
• at the slightest touch and processing begins;
• during the diagnostic palpation pain is felt and tissue compliance is observed;
• sometimes pus is released;
• the size of the running periodontal pocket is increased so much that the gap with its contents is visible to the naked eye during visual inspection;
• teeth are getting stronger even though they are healthy;
• gaps also appear between units in a row and space is freed;
• deteriorates with severe intoxication general state patient, which is expressed in weakness and other symptoms.

With any of the individual signs mentioned, you need to get an appointment with a dentist as soon as possible in order to stop the development of the disease and prevent complications.

The reasons

This pathology occurs in many patients, but most often the following factors contribute to this:

• the habit of eating improperly, the abuse of carbohydrate foods;
• illiterate actions during hygiene procedures, and even completely neglect them;
• some bad habits(for example, smoking);
• general systemic diseases that contribute to the spread of infection throughout the body;
• hormonal disorders in different periods human life;
• low level of the immune system;
• untreated dental diseases.

Indications and contraindications for the procedure

In cases of formation of deep periodontal pockets and their pathological inflammation, curettage is performed. different ways. What it is? This procedure helps to qualitatively clean the infected area and prevent the spread of bacteria to surrounding tissues.

Only in this way can complete treatment and achieve high efficiency. Most often, the following indications for curettage are distinguished:

• the onset of inflammation of the mucosa;
• the formation of a noticeable gap between soft and hard tissues;
• abundant deposition of tartar in the subgingival region.

Although curettage is in some cases prohibited or undesirable:

• purulent discharge and suspicion of soft tissue abscess;
• the formation of cavities in the bone structure;
• too deep periodontal pocket - more than 5 mm;
• thinning gums;
• the onset of fibrotic tissue changes;
• extreme loosening of teeth;
• acute infections in the oral cavity;
• some common diseases.

How is the treatment carried out?

What is curettage done? To do this, use a special dental instrument - a curette. It is thin enough to carry out the necessary treatment of the root region of the tooth even without opening the tissues.

Sometimes doctors resort to modern way – laser curettage. For this, apply special equipment and painlessly perform high-quality cleaning of periodontal pockets and restoration of affected tissues.

In addition, specialists can perform other activities to cleanse and treat periodontitis - antibiotic therapy, other methods of removing dental plaque, anti-inflammatory drugs and even physiotherapy methods. But the best result There are two types of curettage - open and closed. All other methods remain auxiliary.

Don't need to be confused this procedure with preventive. Indeed, in the second case, only the processing of the visible surfaces of the enamel and its polishing are performed.

Completely get rid of subgingival deposits, bacterial accumulation and an increase in periodontal pockets is possible only surgically, which will prevent re-inflammation and ensure cleanliness and tissue regeneration.

Open curettage of the periodontal pocket

This technique is chosen in cases where the size of the gap is set to more than 5 mm or the closed technique did not give the desired results. Surgical opening of the gums is performed for a better view of deposits, better processing, elimination of granulation and additional procedures.

So, at the same time, splinting can be carried out to fix the dentition, build up bone tissue and fully cure and restore the mucosa. The doctor performs the following manipulations:

1. Spend general diagnostics and determine the need for surgery.
2. Further, some preparation is required - the desired area is treated with antiseptic agents, and the patient is given local anesthesia.
3. The mucosa is opened with small incisions to access the root of the jaw.
4. The necessary high-quality cleaning is carried out, all the remnants of the vital activity of bacteria, dead cells, damaged tissue areas, etc. are removed.
5. If necessary, an osteogenic preparation capable of short time increase tissue volume.
6. The mucosa is sutured, and upper part pull up to the necks and fix.
7. After ten days, with a normal degree of healing, the sutures are removed.
8. For processed wound surface apply a special bandage with therapeutic agents.

The total healing time can take up to 2-3 months. In this case, the doctor prescribes antibiotics, anti-inflammatory and painkillers, as well as rinsing or other auxiliary procedures performed at home.

In one such operation, a specialist can simultaneously process up to eight units located in a row. In addition to cleansing, a partial build-up of periodontal tissues and a reduction in the formed pocket are carried out. This procedure can only be carried out by an experienced doctor with sufficient high level qualifications.

Closed curettage of the periodontal pocket

This method of treatment and cleaning of the resulting gap is selected in cases where the size of the pocket does not exceed 3 mm. As a result, it is possible to treat the subgingival area with only simple instruments.

True, the technique has disadvantages:

• when conducting one session, only 2-3 units in a row are available;
• visual control over the actions and quality of work is impossible, all manipulations occur blindly;
• because of this, and also as a result of difficult access, the doctor cannot completely clean the periodontal pocket, there is high risks the fact that part of the granulation formations will remain in place, which will lead to re-inflammation.

But this operation happens without mechanical damage tissues, without opening them, which facilitates the patient's sensations and accelerates the healing time. In the process of such curettage, it is possible to reduce a deep periodontal pocket or completely get rid of a small gap.

The steps themselves are quite simple:

1. Perform local anesthesia.
2. With the help of a curette, the walls of the tooth and the subgingival area are treated, carefully cleaning the bottom of the pocket.
3. The accessible area is washed with a solution of sodium chloride.
4. At the end, a bandage is applied that can accelerate healing and protect weakened tissues from external influences on the postoperative period. Usually, stomalgin, zincoplast or repin are used for this.

After 1-2 months the patient feels complete healing. True, at first there are pain, increased irritability of the mucosa and mobility of the crowns.

Possible consequences

Curettage of periodontal pockets is considered one of the most effective methods for the treatment of periodontitis and other inflammatory processes in soft tissues oral cavity. However, in some cases, complications or lack of the expected result are possible. This happens if:

• the doctor does not have the proper level of qualification or experience and does not thoroughly clean the cavity;
• granulomatous formations remain, which eventually grow again;
• some individual characteristics the patient's body, which sometimes leads to unforeseen results;
• too much great depth pocket when more serious intervention is required.

Video: how is closed curettage of periodontal pockets performed?

Price

The cost of the procedure depends largely on the level of the clinic in which it will be performed, the region of residence, the number of units processed and the complexity of the manipulations. Usually average price in Moscow it fluctuates between 500-6000 rubles per tooth in the open way and 350-1200 rubles in the closed way.

If we talk about segments or cleaning the entire jaw, then prices vary more here. So, for one processed segment, some doctors charge a fee of 3,000 rubles, while others charge up to 20,000. laser procedure also turns out to be significantly more expensive than any other treatment.

AT dental clinics patients are often prescribed a curettage procedure. What is it, why is it recommended to conduct it, what are its features, let's try to figure it out.

This procedure is used to eliminate gum disease. The method is very effective and here's why. There is a recess between the edge of the gum and the cervical region (it has a different dental name-), in which food safely enters. Leftover food often accumulates in the pocket.

Food remains are difficult to clean with a brush, the painful microflora continues to develop rapidly. Inside, various kinds of deposits are formed that come to the surface of the exit of the tooth from the gums. As a result, it forms, which is quite firmly connected to the tooth enamel and is introduced into the space between the gums.

Significant changes begin to occur in the bone tissue itself: dentin atrophies, the root becomes cemented, everything becomes overgrown granulation tissue. In the place where the bone tissue has collapsed, a gum pocket is obtained.

Bacteria begin to multiply very actively in this pocket. As a result, it starts dangerous disease periodontitis. Even more dangerous complication considered periodontitis. The teeth are loosened, and on the very last stage fall out. Such a disease is treated for a very long time. Unfortunately, the prognosis for recovery is not always positive. If you do not cure the disease in time, you can lose all your teeth.

It turns out that the curettage procedure is simply mandatory for periodontitis, periodontal disease, and other complications.

The procedure is shown to people:

• with inflammation of the gums;
• with a pocket larger than 3mm;
• with large deposits of plaque;
• with a high degree of tartar formation.

A remark should be made immediately: the procedure for professional cleaning and curettage is Different things. At professional cleaning processed only outer surface tooth. Curettage helps not only to clean the teeth, but also to remove all decay products from the pocket.

The procedure of curettage solves many problems, namely:

• cleans the peridental area;
• removes the periodontal pocket;
• cleans the granulate;
• completely eliminates bleeding gums.

Types of curettage

1. Open curettage. The procedure is carried out in severe cases. Especially often this method is used when pockets are formed in bone and soft tissues. In this case, a gum incision is always used.
2. Closed curettage. The procedure is used for cosmetic whitening of the surface of the teeth or during cleaning of the oral cavity from tartar. Here, the opening of the gums is not resorted to at all.

Closed curettage is done if:

• in a patient mild form periodontal disease;
• at patient's mild form of periodontitis;
• there are no pockets in the bone tissue;
• there is a need to maintain the density of the gums;
• there is a need to preserve the gum structure;
• the patient's depth closed pocket less than 5 mm.

Open curettage is done if:

• there are lesions of the interdental papillae;
• there is a severe form of periodontitis;
• there is extensive tartar on the teeth;
• gum pocket moved away from the tooth;
• the depth of periodontal pockets is more than 5 mm.

On the certain time the curettage procedure may be delayed. The reason for this is the inflammatory process in the oral cavity.

Instruments for the procedure

The procedure can be performed using mechanical instruments or ultrasound.

Most modern dentists prefer to use ultrasound. The procedure is distinguished by its efficiency, speed and painlessness.

In order to cure the patient one hundred percent during ultrasound treatment be sure to polish the root of the tooth. This method allows you to make the tooth enamel smooth and prevent the appearance of tartar.

The doctor often prescribes medical preparations, which disinfect the oral cavity and help the gums resist bacteria.

How is the procedure carried out

First of all, the doctor makes an examination and diagnosis of the gums. Next, he treats the entire cavity with an antiseptic. In order to reduce pain after the injection, the doctor applies a cooling gel to the surface of the gums. Then the patient is given an injection with anesthesia. Next, the doctor cleans the deposits in the gum pockets. Dental instruments are being used. The gum, as mentioned above, is not cut in this case. At the very end, the roots are polished. Be sure to grind the tooth and treat the surface of the gums antiseptic. At the end, the doctor puts an ointment in the pocket itself, which restores the gum tissue well. Closed curettage will take no more than 30 minutes. The duration of the procedure depends on the complexity and volume of work.

With open curettage, gum diagnosis and anesthesia are first performed (as in the first case), then the gum surface is cut. This is simply necessary in order to get to the very bottom of the periodontal pocket. The incision site is the area of ​​the interdental papillae. Next, using dental equipment, clean the pocket. During the procedure, care is taken to ensure that bone tissue grows in the future. To do this, osteogenic preparations are applied to the damaged area. On the last step the incised gum is sutured.

patchwork method

There is another method of curettage - patchwork. During its execution, two incisions are made. In this case, both cuts are vertical. The meaning of the flap operation is to expose the tooth root through the folded flap (which is formed after the incisions). With this operation, the roots are exposed and react strongly to stimuli. If you influence them with temperature or other aggressive substances, then the roots begin to hurt. But these feelings can be avoided. To do this, the tissue of the palate is transplanted to the place of the cut piece. The procedure justifies its effectiveness: the pockets are cleaned and aesthetic appearance does not deteriorate.

There are difficult cases when bone tissue transplantation is required. This may require the material of the patient or some other (non-live, synthetic).

Thanks to transplantation, tissue regeneration occurs. As a result, the tooth in the hole is securely fixed.

The sutures are removed approximately 1.5 weeks after the dental intervention. But herself damaged tissue takes much longer to recover. The final recovery will take several months.

rehabilitation period

After the curettage procedure is rehabilitation period. If a special bandage has been applied to the gum, then it is impossible to brush your teeth with it and do harmless rinsing of the mouth. In the early days, only semi-liquid food should be included in the diet.

After removing the bandage, you can do the procedure for rapid healing at home. Usually this is treatment with anesthetics and agents that help the wound heal faster. You should know that home care important. Responsibility in this matter will help prevent re-infection in the deepening of the gums.

After the end of curettage, you need to go to the dentist. The very first appointment is scheduled after about two months. Only after this time it becomes clear how successfully the procedure was carried out.

The issue of cost is not an unimportant aspect of treatment. The cost of curettage includes not only the payment for the work of the doctor, but also the cost of materials. For one tooth, you will have to pay about two thousand rubles.

If a doctor, a competent specialist, says that you need to do curettage, do not refuse. The disease will lead to the release of pus, to severe instability of the teeth and to their loss. If there is a desire to restore them, then implantation will be required. If the disease has gone to a serious condition, then it is necessary to start acting as soon as possible.

Well curettage

After the removal procedure, cleaning of the well is required. If this is not done, then the gum will begin to bleed in the near future, the teeth will hurt a lot and a strong inflammatory process will begin.

If a painful symptoms disturb the patient for more than 5 days and at the same time it does not become easier, it is necessary to run to the doctor. Microorganisms have formed inside the wound due to food debris or foreign objects. Sometimes there are fragments of bone that have begun to rot. Another soreness occurs due to the inflamed pulp.

A sick tooth can transmit an infection neighboring teeth, therefore it is necessary to carry out curettage.

Curettage of the hole is done in the following sequence:

1. The application is applied to the patient and anesthesia is done.
2. Carry out the release of the alveoli from the blood clot.
3. Removed with dental instruments foreign bodies, tooth fragments and other elements.
4. The hole is treated with an anesthetic.
5. Tampons are applied (in the process of treatment, an incision and suturing is not performed).

The whole process is carried out in one procedure.

At first glance, the interference appears to be minor. But it's not. After the operation, it is imperative to follow the recommendations for the entire rehabilitation period.

After brushing your teeth, you should perform this procedure with extreme caution. To clean your teeth, you will need a tool with very soft bristles. It can be purchased at the store in advance.

Contraindications

You should not do the procedure if:

• have gingival fibromatosis;
• there are the slightest contraindications to surgical operations;
• there are infectious processes in the oral cavity (for example, tonsillitis);
• have any infectious diseases (ARI, influenza);
• there is pus in the gum;
• deep bone pockets are observed;
• the gum itself is very thin;
• the dentition has an abnormal location;
• the patient's jaw is underdeveloped;
• there is a purulent tumor;
• tooth mobility is observed.

• To alleviate the condition, cold compresses should be applied. Inflammatory processes slow down and pass over time.
• If an open curettage was performed, then the first few hours should be drunk through a straw. This will prevent bleeding.
• Do not eat or drink hot food until almost complete tissue healing.
• Apply daily antiseptic preparations. For example, Miramistin and Chlorhexedine. They need to wipe their teeth after and every meal.

Advantages and disadvantages of curettage

The benefits include the following points:

• Closed curettage is inexpensive: 200 rubles per pocket. Open curettage of one tooth: about 2000 rubles.
• It is possible to completely restore bone tissue (osteopreparations help well in this).
• Complete elimination of gum pockets and the removal of pathogenic microorganisms in them.
• Mobility of teeth after treatment completely disappears. After curettage, the teeth sit stronger in their sockets.

The disadvantages include:

1. Not effective for periodontitis.
2. Closed curettage is an expensive method.
3. In terms of time, open curettage lasts quite a long time (it takes 2 hours to process seven teeth).
4. The doctor who will carry out the curettage procedure must have high category and be an expert in your field.
5. If the patient gets on an inexperienced dentist, then wounds and damage to the mucous membrane are provided to him.

Reviews

I had an open curettage this year. I'm a man, I shouldn't complain, but I'll be honest, this is a terrible procedure. After the treatment, I could not hold anything in my mouth for several days. All exhausted during this time. My whole gum was terribly sore and sometimes blood came out of it. Of course, they gave me anesthesia, but I still felt a lot (or so it seemed to me, I don’t know). However, I will say that I was pleased with the result. The gums now have a healthy color, blood does not come out of it at all. What particularly pleased me was the absence bad smell which has been bothering me for several years. I endured great torment not in vain.

I went to curettage knowing what it is painful procedure. A doctor friend suggested that I do the procedure. I really wanted to have healthy teeth and I trusted him. Of course, I was pleased with the anesthesia during the treatment. A big plus is that I went to the hospital on time, on the very initial stage. My disease was not advanced and therefore quickly succumbed to easy treatment.

The procedure will definitely make you healthy and beautiful. I had terrible deposits near the tooth and a sickening smell from the mouth. The doctor advised curettage. For treatment, the doctor took terrible instruments from which I wanted to run away. I will describe the procedure. At first I was given 2 injections. It is important to get to a specialist who knows how to do them. A person should have a very light hand. After anesthesia, the doctor began to pull something out of my teeth with a thin needle. I didn't feel anything. Heard only loud noise drills. I felt fear and a little fear, because I understood that they were cleaning the space between the gum and the edge of the tooth. I was in the doctor's office for 30 minutes.