Curettage of periodontal pockets. The course of the open curettage procedure. Open curettage specialists

Unfortunately, no one is immune from the appearance of a periodontal pocket due to structural damage or periodontal disease (tissue surrounding the tooth). With a structural lesion of the tooth (cracks, fractures, perforations), it must be removed. In this case, it is not necessary to treat the canal (including the need to use open curettage of periodontal pockets).

Prices for open curettage

Open curettage for periodontal diseases in the area of the 1st quadrant 28786 P

Open curettage specialists

Weitzner Elena Yurievna

periodontal surgeon candidate medical sciences

2006 - Graduated with honors from the Moscow State Medical and Dental University. Evdokimova

2006-2007 - Internship at the Department of Dentistry general practice and Anesthesiology MGMSU

2007-2009 - Clinical residency at the Department of Hospital therapeutic dentistry, Periodontology and Geriatric Dentistry MGMSU

Litvin Irina Borisovna

doctor of the highest category dentist-therapist

1991 - graduated from the Moscow State University of Medicine and Dentistry. Semashko specializing in dentistry.

1991-1992 - passed a clinical internship on the basis of the Zelenograd city polyclinic, specializing in therapeutic dentistry.

1995 - graduated from advanced training courses at the faculty of advanced training of dentists of the Ministry of Health of the Russian Federation.

With periodontal disease, pockets are:

false when the ligament of the tooth is preserved, and the canal is formed by an overgrown gum (such canals are treated with a section of excess tissue);
true when the ligament of the tooth is broken, and the goal of treatment is to restore it; to do this, it is necessary to clean the root surface and remove the changed gum tissue.

In the second case, the treatment tactics depend on the depth of the pocket:

with shallow pockets (up to 3 mm), the root is cleaned with curettes using a procedure called closed curettage;
with pockets from 3 to 5 mm deep, a procedure is applied that is called open curettage;
for pockets with a depth exceeding 5 mm, it is necessary to correct soft tissues and bone tissue around the tooth; in addition, the root must be cleaned, so a patchwork operation is used.

The treatment strategy depends on each individual. clinical case and is determined after a thorough examination, so we are waiting for you at the Center aesthetic dentistry».

Video about open curettage

Open curettage of periodontal pockets: what is it?

So, based on the above, open curettage is a dental procedure that is performed in the treatment of periodontitis, if the depth of the periodontal canals is from 3 to 5 mm. Deposits that accumulate over time in the periodontal canals cause inflammation of the gums and the development of periodontitis.

Open curettage of periodontal pockets involves the following manipulations:

Stage 1.
after local anesthesia, deposits are removed from the surface of the teeth above the gums;
Stage 2.
then the gum is dissected to open access to the roots of the teeth;
Stage 3.
after that, with the help of special instruments (curet), dental deposits in the periodontal canals are removed;
Stage 4.
the cleaned canal is washed with a special antiseptic preparation and the root of the tooth is covered with a solution that promotes bone tissue regeneration;
Stage 5.
after such treatment, the dissected gum is sutured.

You can see what open curettage looks like in the photo. In some cases, open curettage with bone grafting is required.

Photos with examples of open curettage

Recovery period

Since this procedure is essentially a surgical intervention, after its implementation it is recommended to remove the puffiness from the dissected and sewn gums with cold for 2-3 days. These days you are contraindicated in food, which must be carefully chewed. You can brush your teeth, but this must be done very carefully so as not to affect the postoperative wound. Rinse your mouth with herbal solutions.

Why should you contact us?

Price for this species procedures (including those with bone grafting) in the Center for Aesthetic Dentistry group of clinics are acceptable for Moscow.
We have experienced professionals who have been doing such operations for many years. The clinics have all the equipment, tools, medicines necessary for this.
Ideal in all clinics antiseptic conditions and a welcoming atmosphere, because we employ only polite and responsive specialists who are ready to provide you with any dental care.

Serious disease periodontitis develops in many people who ignore regular and high-quality hygiene. oral cavity. The disease causes a lot of problems and complications, and some of them require curettage or patchwork operations on soft tissues. In this article, we will consider what kind of “curettage of teeth” procedure is, the need for it, all the pros and cons of the event.

Due to inadequate hygiene, hereditary factors, anatomical features or the patient's diet in the mouth appears a soft layer of microbial plaque, protein deposits, dark and hard stone. Actively multiplying in them, bacteria trigger inflammatory processes in the teeth and surrounding soft tissues.

The patient begins to complain of bleeding gums, gropes for swollen areas of soft tissues, touching which is accompanied by severe pain.

In case of absence effective treatment periodontal disease leads to tooth mobility, a change in their position and even loss, and inflammatory processes are characterized by the appearance of pus from under the gums, a general deterioration in the condition.

Curettage - cleaning periodontal pockets

Against the background of all these processes, the patient develops two critical conditions.

Surgical treatment in this case will clean the channels and granulation tissue, contributing to the improvement of well-being.

Large voids (starting from 4 mm), once appeared in the body, do not go away on their own, even after effective treatment with anti-inflammatory drugs, antibiotics, dental procedures(laser, ultrasonic, hygienic, etc.). Even if you sign up for a stone and plaque removal procedure, the dentist will not physically be able to clean periodontal pockets using standard equipment. And if there are deposits, then inflammation remains, and further destruction of the bone and teeth.

Even if it was possible to clean the pockets and stop the inflammatory process, anatomical changes remain in the body that contribute to regular relapses of periodontitis.

So, curettage of the periodontal pocket remains the only way guaranteeing a complete cure for the disease.

It promotes:

removal of voids filled with pathological contents;
cleansing the teeth from subgingival stones and deposits;
cleansing periodontium and bones from replacement tissue.

There are 2 methods of curettage: open and closed.

Closed technique

It is prescribed to remove subgingival microbial plaque, as well as granulation tissue from pockets.

The technique is effective only when the depth of voids does not exceed 3 mm(initial forms of periodontitis). If the disease has progressed severe forms, the private method will only help to pause the process.

This type is performed in clinics where there is no qualified periodontal surgeon. The operation is undertaken by dentists-therapists who do not have sufficient experience and qualifications to perform more complex manipulations (open curettage or flap surgery on the gums).

Closed curettage

How is the procedure carried out? The nurse administers local conduction anesthesia and the doctor proceeds to clean the pockets with manual or ultrasonic instruments. The dentist carefully removes subgingival soft and hard deposits, looks deep into each pocket, removing replacement tissue and pathological masses from its cavity. The cleaned cavity is washed isotonic saline based on sodium chloride. Then the doctor polishes the tooth roots.

After the event, the doctor recommends wearing special dressings (for example, stomalgin, zincoplast, dentol and others). Within 4-5 hours after the session, the patient should not eat or drink aggressive liquids. It's better to limit yourself plain water without gas at room temperature.

A month after the closed procedure, the doctor examines the depth of the pockets. As a rule, the shallowest of them disappear, and the deep ones are reduced.

Open method

An open curettage of periodontal pockets is prescribed to eliminate inflammatory processes, remove subgingival deposits, and replacement tissue. This procedure also allows you to completely remove periodontal pockets and promotes the restoration of natural bone tissue, for which the doctor "plants" artificial material.

Before the operation, the doctor performs necessary training . Professional cleaning of the entire oral cavity from plaque, tartar and pus is carried out, teeth are splinted (if necessary), a course of therapy with antibiotics and anti-inflammatory drugs is prescribed.

At the appointed time, the patient is given local conduction anesthesia. The operation is performed on a specific area, including no more than 8 teeth.

Open curettage

An open procedure involves the periodontal surgeon exfoliating the mucous tissue of the gums.. To do this, the doctor performs small incisions in the area of the dental necks. The resulting flaps are taken away from the bone, exposing the dental roots and areas of destroyed bone. At this stage, the doctor fully sees all subgingival stones and plaque, as well as granulation tissue. He removes these pathological formations(including pockets) using surgical curettes. Modern clinics allow scraping replacement tissue and stones with an ultrasonic scaler. In the same way, a periodontal pocket can be removed (photo below).

Such an artificial material stimulates the restoration of its own tissue, which will significantly reduce the depth of the cavities.

Curettage by ultrasound

The last step is suturing in the area where the interdental papillae are located. Also, a special bandage is attached to the area, which protects the wound from infection and promotes tissue regeneration. The doctor removes the stitches after 10 days.

For several days after the operation, the patient is forbidden to perform standard hygiene procedures(cleansing with a toothbrush, interdental brush, floss, irrigator) in the intervention area. The specified area should be treated with a swab moistened with an antiseptic or anti-inflammatory agent.

A month later, the dentist conducts a control probing depth of bone pockets and may prescribe a second procedure.

Pros and cons of the procedure

Curettage has collected both positive and negative feedback doctors and their patients, which we will give below.

The closed technique has several advantages.: the doctor can remove deep subgingival deposits, clean the pockets from the pathological mass, which may help to reduce their volume.

Also, manipulations take little time, and rehabilitation is quite fast. In addition, the procedure is available for the middle strata of the population.

The operation also has many disadvantages:

it is not prescribed in case of moderate or severe periodontitis;
in 99% of cases causes relapse and progression of the disease;
the procedure is carried out blindly (the doctor does not see the depth of the pockets, the surface of the roots), so some pockets may not be completely cleaned, and deposits and granulations are not removed.

Regarding open gum curettage, then here good points much more: the doctor not only cleans the periodontal pocket, but also removes it, which allows you to stop periodontitis without the possibility of recurrence. The implantation of artificial tissue allows to reduce the depth of defects-voids in the bone, which will also eliminate tooth mobility.

Open curettage takes about 2 hours

The disadvantages of the technique, unfortunately, are:

the qualification of a periodontal surgeon must be high enough to perform a complex operation;
the procedure is expensive: the work of the surgeon and the nurse is paid, as well as expendable materials, which include expensive artificial bone and monofilament for suturing;
possible after the procedure unpleasant consequence- gingival prolapse, which leads to exposure of the tooth roots and related complications;
the gingival papillae become flatter for several months, which makes the interdental spaces deeper;
the operation takes enough time (about 2 hours) and requires rehabilitation (limited hygiene of the area, care with special anti-inflammatory drugs, soft food diet, etc.);
the event is ineffective in the presence of pathologies: thin gum tissue, deep pocket or large pocket volume, abnormal structure of the dentition, pocket festering, etc.

When choosing between 2 types of procedure, remember that only open curettage makes it possible to permanently stop the disease and try to restore the lost bone tissue.

Usually, it is not possible to solve the problem without surgical intervention in the course of complex treatment. Curettage allows you to remove the pocket between the tooth and the gum. The procedure involves: removal of tartar, scraping of granulations from the walls of the gums and the bottom formed cavity, fabric processing antiseptic preparations, the imposition of protective bandages.

Indications

There are a number of indications that require curettage of the periodontal pocket:

inflammation of the gums;
the formation of cavities between the wall of the tooth and gums;
the occurrence of abundant deposits of tartar;

Curettage of gingival pockets should not be considered as an alternative professional cleaning enamel. In the latter case, only the removal of plaque and polishing of surfaces is carried out. Complex treatment pockets in the gums not only help to get rid of deposits, but also to eliminate the flow pathological processes in tissues and avoid their decay.

Contraindications

Treatment of periodontal pockets by curettage is contraindicated in case of purulent discharge, suspected tissue abscess, presence of pockets in the bone structure, expansion of periodontal cavities to a depth of more than 5 mm. It is forbidden to carry out the procedure with extreme thinning of the gums, their fibrous change, tooth mobility of the 3rd degree.

Curettage of the periodontal pocket - types

There are several types of procedures:

Open curettage - required when opening pockets to a depth of 4 to 5 mm. During the event, the affected area occurs, which makes it possible to gain open access to the preparation of the roots of the tooth and perform a deep cleaning of the tissues.
Closed curettage of periodontal pockets is performed with a shallow canal depth. The procedure does not require a gum incision.
Patchwork gum - not only pockets are cleaned, but also deep surfaces,. To restore the structure of the tooth, artificial materials can be used that stimulate the growth of new tissue.

Flap surgery on gums

Open curettage

The operation is relevant when the depth of pathologies is more than 5 mm. In addition, the method is resorted to if the treatment of gum pockets in a closed way brought no results.

A prerequisite for carrying out is a surgical dissection of the affected gum. Open curettage of periodontal pockets is carried out in several successive stages:

The condition of the gums is diagnosed.
Local anesthesia is performed.
The gums are dissected in the area of the interdental papillae, which facilitates access to the base of the pockets.
The fabric is cleaned using a specialized tool.
For the purpose of restoring bone pocket treated with osteogenic stimulants.
At the end of the operation, the gums are sutured.

It is carried out if the pocket in the gum between the teeth has a depth of up to 5 mm. The operation is performed without surgical intervention and consists of the following activities:

General diagnostics of tissue condition.
Local anesthesia.
With the help of a special tool, the periodontal pocket is cleaned without disturbing the structure of the gums.
The tissues of the roots of the tooth are polished.

The closed method allows you to reduce the deep periodontal pocket and completely eliminate the small one. The operation causes less discomfort for the patient compared to the open method of preparation. Therefore, closed curettage looks preferable if there is an opportunity for its implementation.

Closed

Flap operation

The method involves cutting out the periosteal surface of the gums, followed by processing of the root and internal soft tissue. Flap surgery for periodontitis provides good visual control, which contributes to the convenient removal of pathological material.

During the recovery phase, a number of complications can occur. First of all, this is an increase in the likelihood of exposure of the necks of the teeth, a change in the alveolar processes, dentin hypertension and aesthetic defects in the outer tissues.

Features of the patchwork operation and its consequences

Periodontal treatment in this way involves the sanitation of the oral cavity, local anesthesia and the use of antiseptics. Further to the transitional fold, starting from the edge of the gum, several vertical incisions are made. Two more incisions are created on the vestibular and oral sides with a 2.5 mm indent. The cut pieces of tissue are removed. In order to preserve the natural material, one horizontal section is allowed, similarly open curettage.

The prepared gum is exfoliated, the periosteal flap is folded back to the transitional fold - the movable area of the mucous membrane. The pathological root cement is removed. The gum pockets are cleaned. Tooth roots are polished with periodontal burs and rasps.

Pocket cleaning

Upon completion of processing hard surfaces, soft tissues are dissected. Subsequently, the ingrown epithelium is removed, granulation tissues are truncated. Alveolar osteoporotic processes are processed, the surgical wound is washed with antiseptic solutions.

If the dissection of the gums has exposed bone defects, the anatomical structure of the tissues is restored using artificial transplant material. The flaps are placed in place, after which surgical sutures are applied. Finally, the prepared tooth is covered with a protective dressing.

For several weeks after the operation, the mobility of the teeth is noted. Then the effect gradually disappears. Additionally, there may be an increase in the sensitivity of tissues to temperature and chemical irritants. Discomfort may persist for up to a month.

As practice shows, brushing your teeth with a desensitizing paste helps to eliminate discomfort after the operation. The consequences of the procedure may be bruising and swelling that disappear naturally after 2 weeks.

Closed and open curettage at first does not allow you to open your mouth wide. Functions are restored jaw muscles for 5-10 days.

Postoperative period

In order not to open the prepared periodontal pockets, after the operation, you should refuse to eat and drink. During the first 10 hours it is forbidden to brush your teeth, rinse your mouth, actively spit saliva.

In order for gum surgery to give the expected result, it is necessary to gently brush your teeth using a brush with soft bristles. Cleaning the oral cavity should be carried out bypassing the problem area.

prepared gum pockets it is necessary to periodically rinse with salted water or a solution of chlorhexidine. It is acceptable to apply cold compresses to outside postoperative area during the first hours after the procedure.

Salted water

At first, liquid, pureed and soft food is taken. Cold and hot drinks are prohibited. For a week, after the curettage of periodontal canals has been performed, it is worth refusing physical activity, lessons contact species sports, sauna visits.

In the postoperative period, it is necessary to resort to the use special means for oral care sensitive teeth. Additionally, you can contact your dentist for a number of activities that will reduce the sensitivity of the necks of the teeth.

Quality Criteria

Cleansing the cavities from granulation material stops the processes of resorption of damage. The use of restorative bone-forming substances stimulates the growth of the missing tissue. In general, the operation should close the tooth pocket, relieve tissue inflammation, and remove hard deposits.

Price

The price of curettage is on average from 200 to 500 rubles for the procedure by the closed method and from 300 to 1000 rubles for the open method of preparation. The specified range varies slightly depending on several factors.

Technical capabilities, the level of equipment, the availability of materials, and the quality of anesthesia come first. Important human factor- the characteristics and nature of the disease in a particular patient. The cost of service is affected by the class and experience of the specialist, the status of the clinic, feedback on curettage from regular customers.

More expensive - laser curettage of periodontal pockets, which does not use traditional surgical instruments and the procedure is quick and painless.

laser

Such an important procedure for health and future well-being is best performed by contacting a dentist with a good reputation, regardless of the financial background.

Finally

As can be seen, despite different approaches to the operation and methods of gaining access to the area of development of pathological processes, to eliminate the pocket in the gums allow methods that have common features. The described methods are primarily aimed at removing granulations, dental and subgingival deposits, ingrown oral epithelium, cement of an infected tooth root. In other words, in all cases, the formed pocket is eliminated, the same tissues are truncated, but using different approaches.

Periodontitis treatment methods: essence, features, reviews
This article was written by a periodontist with more than 20 years of experience.
Here you can find out:

the nature and characteristics of such a disease as periodontitis;
reasons why surgical treatment is necessary;
existing methods of surgical control of periodontitis;
advantages and disadvantages of the presented methods;
feedback from patients on the effectiveness of each type of operation;
the answer to the question, what is the best way to treat periodontitis.

For a complete understanding of the need surgical treatment periodontitis, it is necessary to consider the process of its occurrence.

Causes, features and consequences of periodontitis

If a person does not pay enough attention to oral hygiene, plaque can form on the teeth, as well as hard deposits - these are obvious factors in the development of periodontitis. Inflammation of the gums begins, and, at first, this manifests itself through their bleeding, and later the mobility of the teeth occurs, they can shift, pus can come out from under the gums.

Thus, initially soft plaque due to mineralization becomes tartar, the microorganisms of which produce toxins. These toxins induce an inflammatory process in the gums, which results in various adverse effects.

First, the bone tissue around the tooth begins to gradually dissolve. It does not just disappear, in its place there is another - granulation - tissue containing many microbes that also dissolve the bone. Thus, bone tissue atrophy occurs many times faster.
Secondly, periodontal pockets are formed. Inflammation causes the destruction of the attachment of the tooth to the bone (the so-called periodontium). With the help of periodontium, the tooth is securely attached to the bone tissue with microligaments.

As for the periodontal pocket, it is an area where the bone tissue is destroyed, and the cavity itself is filled with pus, granular tissue and dental deposits. In the people, the periodontal pocket is also called gingival or dental. Such a disease can be detected in a patient using an x-ray or by probing.

If, as a result of examination, deep gingival pockets (from 3-4 mm) are found in a person, then no therapy and antibiotics can help in this case, since the destruction process becomes irreversible.

There are several reasons for this.

Not even the most highly qualified specialist is able to give a 100% guarantee that with the introduction of an ultrasonic nozzle under the gum, all subgingival deposits will be removed. This is due to the fact that the doctor cannot see what exactly is happening in the gum pockets. Therefore, in almost all cases, there remains a lot of destructive deposits.
Moreover, such a procedure is very expensive and painstaking, it takes a lot of time, effort and money, and guarantees complete cure- No.
Even if we assume that subgingival deposits have been completely removed from the pocket, periodontitis will still progress, since there are all conditions for favorable development infections.

The only way out that can guarantee improvement is surgical intervention. Only it can completely remove all deposits, granulation tissue and periodontal pockets.

Types of periodontitis treatment with surgery

There are three main methods of operations for this disease: open and closed curettage of gingival pockets and flap surgery. Consider the features of each of the methods in more detail.

Closed curettage of periodontal pockets

aim closed curettage is to get rid of granulation in periodontal pockets, as well as subgingival dental deposits. But the technique has a significant drawback - during the curettage, there is no overview of the root surface and periodontal pockets, so granulations and deposits can remain in their original places, and in a considerable amount.

Effective this technique only if the patient has periodontal pockets up to 3 mm. it mild degree periodontitis. With more complex stages of the development of the disease, curettage can give only short-term relief, and in any case, the progression of periodontitis is inevitable.

As a rule, such operations are performed in clinics where there are no highly qualified periodontal surgeons and operations are performed by ordinary dentists.

It is worth saying a little about the specialty of a periodontist to make it clear how important such a specialist is in the treatment of periodontitis.
A periodontist is essentially a dentist who treats teeth, in most cases it is from periodontitis.

Also this specialist treats gingivitis. This disease is much less dangerous, but gives the "owner" a lot of problems. With gingivitis, the gum changes color and swells, bleeds, and pain(burning, itching, sore gums) and bad breath.

It is important to timely diagnose both periodontitis and less dangerous gingivitis. The periodontist conducts visual inspection and also uses special professional methods diagnostics. Thanks to them, he can timely identify the signs of an incipient disease and provide qualified assistance in a timely manner.

At an early stage of gingivitis, the doctor removes plaque, cleans stones in the gum pockets and smoothes the surface of the tooth root.
On average or late stage there is a need for surgical intervention.

In general, a periodontist treats periodontal diseases, studies the periodontal tissues. In general, his work directly depends on the goal of the patient. Someone may need to check in preventive purposes and receive recommendations to help prevent the occurrence of diseases of the teeth and gums, observe proper hygiene oral cavity.

Other patients need complete diagnostics oral cavity, identifying the causes of periodontal disease and developing effective ways treatment and advice.

Be that as it may, a specialist periodontist is necessary in any highly qualified dental clinic, and in the event of a periodontal disease, one should contact this kind of doctor.

Open curettage of dental pockets

The purpose of open curettage is to get rid of granulation in periodontal pockets, subgingival dental deposits, elimination of gum pockets and stimulation of bone tissue regeneration by implanting synthetic tissue.

The operation is usually performed under local anesthesia. Before its start, a serious and careful preparation. Dental deposits are removed, anti-inflammatory therapy is carried out, etc. As a rule, one segment (7-8 teeth) is operated during one operation.

Consider the course of such an operation

Around the necessary tooth necks, the specialist makes an incision, after which the flaps of the mucous membrane of the gums exfoliate from the teeth. Thus, the root surface and bone defects become visible. The surgeon can now visually observe all pockets and subgingival deposits. Using ultrasound, it removes granulation tissue and all tartar. Then, the roots of the teeth and bone tissue are treated with an antiseptic and the grafting of synthetic bone tissue begins. This procedure is not able to completely restore the tissue, but it helps to significantly reduce the depth and width of the pockets.

A little should be said about synthetic bone tissue. It is an artificial raw material of a powdered form, completely replacing the bone. It is not dangerous for allergy sufferers because it is hypoallergenic.

After bone grafting, a periodontal surgeon in the area of interdental papillae sutures, then a bandage is also applied to the operated area. The sutures are removed after 10 days.

Flap operation

Concerning patchwork operation, then it helps to achieve the following goals: remove granulation tissue from under the gums, clean out subgingival dental deposits, remove gum pockets, and finally, stimulate the restoration of bone tissue by implanting its synthetic analogue. As you can see, these goals are fully consistent with the goals achieved with open curettage.

However, there are differences between these methods. It consists in the fact that during a patchwork operation, the incision is made 1-1.5 mm from the edge of the gums. In the future, this strip of gums is cut out, because being inflamed for a long time, the gum changes and loses its ability to fit snugly against the tooth surface. At the end of the procedure, the flaps of the gingival mucosa are stretched to the tooth necks. This "tension" helps to prevent the "drooping" of the gums.

Flap operations are used both for generalized periodontitis and for the purpose of closing the gingival prolapse in the area of 1-2 teeth and exposing the roots.

We offer for consideration the feedback of patients after testing by them different methods surgical interventions.

Review of closed curettage

This procedure is very short-lived, it is tolerated without special problems. For such an operation, an experienced periodontist surgeon is not needed, a regular dentist or periodontist will do. Moreover, in terms of price, this is the cheapest of all the presented methods of surgical treatment. And perhaps these are the only advantages of closed curettage.

There are more cons.

First, the operation can only help with mild stage periodontitis. The presence of deep periodontal pockets, i.e. with moderate and severe periodontitis, closed curettage is ineffective. You can also say with almost 100% certainty that the disease will certainly develop after such an operation.

Feedback on open curettage and flap surgery

The indisputable advantage of these methods is that they are the only way to destroy gum pockets and stabilize periodontitis. In addition, such operations reduce bone tissue atrophy by replanting its synthetic analogue. This helps to partially cope with the mobility of the teeth.

It is important to say about the disadvantages that are present in most surgical interventions.
Firstly, to carry out such operations, a special specialist is needed - a periodontist-chiropractor, who can currently not be found in every dental clinic.

Secondly, the prices for these operations "bite", and this is not an exaggeration. The patient must pay, in addition to the work of the doctor, his assistant or nurse, also the purchase of expensive materials (monofilament - suture material, synthetic bone tissue others).

During the operation, when the doctor removes granulation tissue and inflamed gums, there is a risk of gingival recession (that is, the gum, as it were, "falls", exposing the roots). The scale of such exposure of the roots fully depends on the size of the bone tissue atrophy.

In addition, a few months after the operation, the gingival papillae are flattened and cannot fill the entire interdental space. And only after a long time period they accept their former form eliminating cavities between teeth.
Finally, the last disadvantage of such operations is the duration of their implementation. Working with one segment (7-8 teeth) takes approximately 2 hours.

The choice of method of surgical treatment of periodontal disease

As can be seen from the presented article and from the reviews of the operated patients, each method of surgical intervention has advantages and disadvantages. On the initial stage The development of periodontitis can be helped by closed curettage, but such an operation is ineffective and its result is short-lived - in the future, it will need to be repeated repeatedly.

For moderate and severe periodontal disease, it is better to choose other methods. The most reliable and viable option can be called patchwork surgery and open curettage, since only they are able to cope with the middle and severe stages of periodontitis, while guaranteeing the cessation of the progression of the disease in the future.

In any case, it is not worth neglecting examination and treatment in specialized clinics, since dental health is a very valuable gift, which must be preserved in adulthood succeeds not for everyone.

The cost of curettage of periodontal pockets

Closed curettage of a periodontal pocket in the area of one tooth 1210 rubles
Open curettage of a periodontal pocket in the area of one tooth 2680 rubles

Some diseases of the oral cavity require a special approach. Often drug treatment is not enough, it is necessary to eliminate the cause of the disease and get rid of its consequences. One of the clearest examples inflammatory process affecting the jaw bones and even the ligaments that can hold the crown in place is periodontitis.

Curettage of the tooth socket will help to cure such a disease. With the help of this procedure, carried out by an open or closed method, the doctor will be able to remove the accumulated plaque and stone with a curette and an irrigator, as well as clean the wells from the waste products of bacteria and viruses.

Periodontal pockets - what is it?

Over time, tartar is deposited, its accumulation can lead to the development of an inflammatory process in periodontal tissues and their further destruction with bone tissue affected. As a result of inflammation, a depression is formed, starting from the gum and ending with the cervical part of the crown, called the "periodontal pocket".

Depending on the depth and width of the pocket between the teeth, the doctor will be able to determine the extent of the disease. Diagnose early stage it is possible with the help of an x-ray examination, and if the inflammation progresses, it can be determined visually. Normally, the recess should not exceed 3 mm - if the gum pocket goes beyond the specified limits, this indicates the presence of a dental disease.

Curettage of the gingival pocket in dentistry

This article talks about typical ways to solve your questions, but each case is unique! If you want to know from me how to solve exactly your problem - ask your question. It's fast and free!

Curettage is medical term meaning cleansing of body cavities, organs or skin using a special instrument called a curette. With the help of this surgical procedure, the doctor removes the affected areas and cleans the areas of accumulation pathogenic microorganisms. Also, the curette will help to produce diagnostic curettage, in order to subsequently transmit the received biological material for laboratory research.

Well curettage is one of the most common medical procedures carried out in the treatment of periodontitis that occurred after tooth extraction. During the procedure, the dentist removes purulent neoplasms, tartar located under the gum, and areas of the destroyed tooth.

Indications for the procedure

A patient at a dentist's appointment may be recommended curettage of periodontal pockets in case of:

Curettage of periodontal pockets is a completely different procedure than cleaning the enamel, in which only plaque is removed. Cleaning the tooth pocket allows you to get rid of accumulated deposits, and also prevents further decay of tissues.

When is treatment contraindicated?

The operation should be abandoned if there are purulent discharge, there is a high probability of developing an abscess, or the gum pocket has spread to bone structures. If the depth of the periodontal pocket is more than 5 mm, the gums are too thin, there are fibrotic changes, or tooth mobility reaches grade 3, then the doctor will refuse to perform this surgical procedure. Also, the procedure for curettage of the hole, in order to avoid complications, cannot be sent if there is acute infection in the oral cavity or with impaired physiological functions.

Pros and cons of curettage

There are several positive and negative sides procedures such as curettage. The advantages of this procedure include:

Unfortunately, there are also disadvantages. Concerning private method, then in advanced stages Periodontitis almost always relapses. Another disadvantage is the duration of the procedure. The patient during the open curettage on 6-7 teeth will have to spend about two hours.

The open method requires the utmost concentration and care from the surgeon. An unqualified doctor can injure the mucous membrane and teeth.

Procedure procedure

Translated from of English language"curettage" is nothing more than "curettage". In dentistry, the meaning of this term is much broader. When conducting scraping for the treatment of gum disease, doctors adhere to the following tactics:

the place of the procedure is treated with an antiseptic solution;
anesthesia is administered;
plaque and calculus are removed from the surface of the teeth (as seen in the photo) using a periodontal irrigator;
the affected area of cement and dentin is removed from the root of the tooth with scraping movements;
the root of the tooth is leveled and polished;
tissue damaged by the infection is eliminated;
an antiseptic agent is applied to the cleaned tissues;
a fixing bandage is applied to the gum pressed against the tooth.

After a correctly performed operation, shown in the video, blood circulation and lymph flow are restored in the gingival canal. Thus, all conditions are created for the speedy regeneration of tissues.

Closed

A distinctive feature of the closed method of treating periodontal pockets is the inability to visually track the condition of the tooth roots, so granulation and tartar can remain intact. The effect of the procedure is possible if the depth of the periodontal pocket is not more than 3 mm (we recommend reading:). With periodontitis, only temporary relief is possible, the disease itself will continue to progress.

A doctor in one procedure of closed curettage of periodontal pockets can clean the cavity of 2-3 teeth, after the procedure, the healing process can take up to a week. Diagnosis can be carried out no earlier than a month after dental intervention. Usually, gum curettage is used only in those dental clinics where there are no highly qualified specialists, and the procedure is performed not by an experienced surgeon, but by a dentist-therapist.

Open

Open curettage allows you to remove all existing subgingival deposits and damaged tissues in the area of one tooth, synthetic bone tissue is implanted, and during the treatment, the gum pocket disappears. Open curettage is carried out under local anesthesia.

In the process laser curettage the surgeon makes an incision in the area of the necks of the tooth, and then exfoliates the gum. The doctor is able to detect all existing subgingival deposits, so that later such treatment allows them to be removed using a curette or irrigator. The area where the operation is performed must be treated with an antiseptic. If the bone pocket is deep, then the doctor uses a synthetic material for extension.

At the end of the operation, the doctor applies stitches, which must be removed after ten days. In the process laser surgery it is possible to dissect tissues without contact, minimize pain and instantly coagulate blood vessels. Restoration of gingival papillae postoperative period happens faster.

Curettage and flap surgery on the gums

The use of flap surgery for inflammation of the gums leads to good results. During the operation, the surgeon has good visual control, so all affected areas are removed. This surgical intervention involves cutting out the periosteal surface of the periodontium, including the processing of root and soft tissues.

Complications are possible in the postoperative period. The necks of the teeth may be exposed, or there will be changes in alveolar processes. Aesthetic defects or the occurrence of dentinal hypertension are also possible.

Is it possible to carry out treatment at home?

If the periodontal period hurts, self-medication at home means deliberately taking risks. Periodontal disease is serious illness requiring medical supervision.

Any folk methods gum pocket treatments at home are ineffective. The patient, trying to clean the pocket in the gum on his own and drown out the symptoms of the disease, wastes precious time.

Help at home various methods, which will be combined with therapy prescribed by an experienced periodontist. For example, gum sockets can be treated using various ointments and gels that can improve metabolism and blood circulation in tissues.

Folk remedies for periodontal pocket disease can also help if we are talking about the initial stage of the disease. Solutions and decoctions help well medicinal plants with antimicrobial and wound-healing effect, they can rinse your mouth.

Possible Complications

If curettage of periodontal canals is carried out experienced doctor and exactly adheres to the methodology of its implementation, then complications can be avoided. However, there are cases when, due to a certain set of circumstances, complications arose:

profuse blood loss;
inflammation in the postoperative period;
secondary infection.

If the doctor is not experienced enough in performing such operations, or the work was done carelessly during the operation, then not all pathogenic tissues will be removed from the periodontal pocket. In this case, the likelihood of relapse is high. The patient needs to re-apply for help to a specialist who is able to perform high-quality cleaning of periodontal cavities.