Surgical periodontology in dentistry. Tasks of surgical periodontology. Tooth crown lengthening

AT last years periodontal disease rightfully attracts increased attention dentists, since after 35 years this is the most common cause tooth loss. There are many periodontal diseases. The nature of the disease is also different, for example, dystrophic, inflammatory or tumor. It should be noted that 90-95% of periodontal diseases are related to inflammatory diseases such as gingivitis or periodontitis. Periodontology is the branch of dentistry that deals with the treatment of periodontal diseases. BUT surgical treatment periodontal diseases deals with the section of periodontology - surgical periodontology. Currently, it is believed that in the moderate and severe form of periodontal disease, it is necessary to use surgical methods of treatment. Namely, resection of gum pockets, including with the use of a laser, regeneration of bone tissue, lengthening of the tooth crown, the use of soft tissue grafts. Let's take a closer look at some of them.

Gingival pocket resection- this is surgery, the purpose of which is the removal of gums that have exfoliated from the tooth. This is done in order to eliminate the gum pocket, which is both a consequence of periodontitis and periodontal disease, and the cause of the progression of these two diseases.

bone regeneration procedure- this is another surgical method treatment of periodontal tissue disease, in cases where bone resorption is noted. The essence of the bone tissue regeneration procedure is that in the place where this bone damaged pathological process, a special protein is established that stimulates the regeneration of bone tissue.

bone grafting performed under local anesthesia through an incision in the gum. During the operation, the patient is performed bone reading from the affected tissues by curettage or using ultrasound. Installed in place damaged tissue protein has different goals: either it does not allow the gum to grow into the area of ​​​​absent tissue, or simply provokes the growth of bone tissue.

Tooth crown lengthening It does not consist in lengthening the tooth itself, but in lengthening the so-called clinical crown of the tooth - that part of it that is visible above the gum. This procedure is the opposite of soft tissue grafts.


And so common manipulation in periodontitis as the application of soft tissue grafts. When the gums are resorbed and can expose the tooth to the root, which makes the tooth more sensitive and the possibility of tooth loss increases. In this case, a soft tissue graft is taken, that is, a small area of ​​the sky, which is transplanted into the affected area. Thus, the tooth becomes protected from external influences.

Surgical periodontology also includes operations for the prevention of periodontal diseases, during which soft tissue plasty is performed, and aesthetic and hygienic operations (flap closure of recessions).

The main task surgical periodontology is the struggle for each tooth, the maximum preservation of the patient's own teeth. But at the same time, patients should remember that surgical treatment aimed at removing infected lesions, as well as restoring destroyed bone tissue, makes sense only if the patient intends to maintain thorough oral hygiene.

Bad breath, bleeding, itching or swelling of the gums are a clear signal that you should see a periodontist. Many people try to save the situation with improvised means: a solution of soda, rinses from the mass market, an anesthetic pill.

But without full treatment In the dentist, over time, inflammation leads to the destruction of the tissues that support the teeth. A pathological space is formed between the crown and the gum, which is gradually filled with various dental deposits, thereby destroying the bone supporting the teeth. As a result, the teeth begin to loosen and fall out.

Why does gum disease occur?

Gingivitis, periodontitis, periodontal disease are the most common forms of periodontal inflammation. The main cause of diseases harmful bacteria accumulated in the form of a colorless film. This film adheres to the teeth, promoting the formation of plaque. Over time, it hardens and forms a rough growth of a porous type - tartar.

The pathological process is accelerated with:

  • malnutrition;
  • prolonged stress;
  • bad habits;
  • poor hygiene oral cavity.

Aesthetic (plastic) periodontics

Experts say that a harmonious smile is 75-100% of the exposed surface of the upper incisors and an even marginal gum line. plastic surgery in periodontics are designed to eliminate congenital or acquired defects of the periodontium, alveolar mucosa and bone tissue.

For cosmetic effect the doctor can:

  • eliminate gum recession;
  • to correct the alveolar process;
  • increase bone tissue;
  • lengthen the coronal part;
  • do frenuloplasty (removal of the frenulum of the lips or tongue);
  • vestibuloplasty (increase in the width of the gums);
  • gingivoplasty (elimination of excess soft tissues).

Surgical periodontology

At serious illnesses soft tissues, when local therapy is ineffective, the dentist has to arm himself with an operating microscope, a scalpel and a thin suture material. By using surgical intervention infected are removed soft tissues and gum pockets.

Pericoronitis is acute inflammation gums caused by problematic wisdom tooth growth. For treatment, a complete excision of the gingival "hood" is performed.

average price in St. Petersburg 2000 rubles

The average price in Moscow is 2000 rubles

Average price in Nizhny Novgorod 660 rub

Surgical periodontics is also indispensable for preparing the oral cavity for prosthetics or implantation.

Innovative technologies that are actively used in modern dental clinics allow you to quickly, painlessly heal gums without damaging healthy tissues.

On our website you can find a trusted periodontist in your area. To do this, specify the appropriate parameters in the search system.

The periodontium is the area of ​​soft and hard tissues that hold the tooth in place. These include: bone ligamentous apparatus and gum. When harmful microbes enter and accumulate on the periodontium, inflammation occurs, which results in various diseases.

Periodontology deals with the treatment of three main types of diseases: periodontitis, gingivitis and periodontal disease. Gingivitis is the first inflammatory process covering only the gums. Periodontitis is a derivative disease in which the infection spreads over more than deep structures: ligaments and bones.

Periodontology department prices

Flap operation in the oral cavity (plasty of the vestibule of the oral cavity according to Edlan) 33866 P

Closed curettage for periodontal diseases (treatment of the periodontal pocket using the Vector apparatus, 1 quadrant) 7671 P

Closed curettage for periodontal diseases (treatment of the periodontal pocket using the Vector apparatus, all teeth) 23013 P

Temporary splinting for periodontal diseases (1 tooth) 4032 P

Gingivectomy in the area of ​​the 1st tooth to lengthen the clinical crown of the tooth 12488 P

Flap surgery in the oral cavity (plasty with a free mucous flap of 1-2 teeth or implants) 20106 P

Flap operation in the oral cavity (coronary flap in the region of 1-2 teeth or implants) 17782 P

Flap operation in the oral cavity (transplantation of a connective flap from the palate) 29633 P

Closed curettage for periodontal diseases (surface treatment of 1 implant with the Vector ultrasonic system) 1842 P

Periodontology 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

Three types of treatment are used in periodontology: surgical, laser and medical. The appointment of the technique is made only after consultation with a specialist and a thorough examination of the patient. The cost of procedures depends on the method of restoration of the periodontal tissue.

Indications for treatment by a periodontist

  • You began to notice that the gum is moving away from the tooth. "Pockets" appear between soft and bone tissue.
  • From the mouth began to appear bad smell for no significant reason.
  • There is blood when brushing your teeth. Last symptom characterizes many diseases that are not related to periodontology, but if blood flows even when you touch the gum with a finger, you should immediately seek the help of a dentist.
  • Permanent bad taste mouth speaks of large cluster bacteria or the presence of food debris clogged in holes or periodontal pockets.

Video about periodontology

What happens if the disease is not treated?

If you constantly put off your visit to the periodontist, the consequences can be detrimental not only physical health but also the family budget. By itself, the disease affects the condition of the teeth and does not cause new diseases, but it can complicate other negative processes in the body or make it difficult to recover.

  • A periodontal dentist should be visited during pregnancy: harmful microorganisms can contribute to premature birth.
  • Accumulated bacteria form plaque inside coronary arteries, which complicates the treatment of angina, heart attacks, ailments of the SS.
  • According to patient reviews, the inflammatory process worsens well-being in the presence of pneumonia. However, such reviews come only from older people.

Photos with examples from periodontology

Stages of periodontal treatment

  • Stage 1.

    Cleaning the roots of teeth from plaque. Specialists polish the bone tissue so that bacteria do not remain on it. The procedure is carried out quite quickly, the technique requires the use of local anesthesia. Ultrasonic cleaning guarantees the quality of processing and the whiteness of the teeth.

  • Stage 2.

    Surgery. Conducted selectively in each individual case. The stage begins after 1-2 months from the end of the first stage. Over the allotted time, pockets shrink and may disappear altogether. If this does not happen, re-cleaning is carried out using surgical intervention. At the same time, the replacement of tissues destroyed by the disease is performed.

  • Stage 3.

    Supportive recovery is essential to avoid recurrence. The procedure includes diagnostic examinations by a doctor, taking prescribed medications.

Photos with examples of periodontal treatment Before and After

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Our network of clinics offers treatment at affordable prices. You can learn about the quality of work, the courtesy of the staff, the convenience of the appointment schedule and other features of our activities from the reviews of patients and check their photos with impeccable smiles.

Reviews of treatment in the center of periodontology All reviews Leave feedback

Thanks to the staff of the Deutsche Welle Clinic

per fast diagnostics and high-quality procedures for brushing teeth - in the photo I look like a different person and do not hesitate to smile.

In this dental clinic I have been in therapy for over two years.

I have been treating at this dental clinic for more than two years. My doctor Mametiev Evgeny Sergeevich. I never thought that you can visit a doctor and not be afraid about the pain. The staff at the clinic are very friendly and knowledgeable. In addition, I was surprised by the adequate prices for splinting of teeth, their ultrasonic cleaning and other procedures. It is worth saying that I chose the clinic for quite a long time. I went for consultations to many doctors (I had periodontal disease). Here, I almost immediately liked everything. The doctor carefully examined me, explained the process of the upcoming treatment, promptly reminded me of the upcoming visit. By the way, I signed up with him for a week, so I think this also speaks of the demand for him as a specialist. In general, if you are waiting for a sincere relationship and professional treatment Come here and you won't regret it. I am sure that I will recommend you and all my family. Thanks a lot.

I really like this clinic

I really like this clinic. I was there earlier on insurance, now I definitely go every half a year to Lidia Goncharova at hygienic cleaning. I did crowns and implants there, five years have passed and everything costs like a glove. The main cleaning is not to forget to visit. Cozy and wonderful atmosphere, thank you all!

Questions and answers about periodontology

Tell me, please, a month ago I accidentally discovered that my lower front teeth were barely noticeably loose, and one was especially strong - noticeably staggering back and forth and darkened a little, went to the clinic there they took a picture and said that I had to either remove and to put an implant, or to do a root resection. Are not only these two methods possible? the tooth absolutely does not hurt, biting even hard writing does not hurt, there is no caries, the picture shows that the tooth itself is absolutely normal, but there is a little circle around the root in the gum dark spot such, they said that this is inflammation due to trauma (although I don’t remember something at all to hit) and that the tooth dies and will fall out soon. But resection is a complex and painful operation, there are complications, is there any other way, let's say, to relieve inflammation with medication, strengthen the gums, etc. ???
Thanks.

  • Surgical periodontology

Surgical periodontology

Methods of treatment in periodontology

Surgical periodontology is a branch of periodontology that deals with the surgical treatment of periodontal diseases. Currently, it is believed that in the moderate and severe form of periodontal disease, it is necessary to use surgical treatment.

Surgical treatments for periodontal disease include:

  • Resection of gum pockets (including with the use of a laser),
  • Bone regeneration,
  • Tooth crown lengthening (gingivectomy),
  • The use of soft tissue grafts.

Gingival pocket resection

Pocket resection is a surgical operation, the purpose of which is to remove the gum that has detached from the tooth. This is done in order to eliminate the gum pocket, which is both a consequence of periodontitis and periodontal disease, and the cause of the progression of these two diseases.

Usually, the gum (which is part of the periodontium) is tightly attached to the tooth. It covers the neck of the tooth from all sides. But when gingivitis occurs, the gum tissue becomes inflamed, looser, more pliable and swollen. This makes it easier for food particles to get into the gap between it and the teeth, which are a favorable environment for the development of bacteria. Gradually, this leads to a deepening of the gum pockets, which even more "accommodate" food particles and microbes, and this in turn contributes to the progression of the disease.

Usually, during resection of the gingival pocket, the gingival margin is excised to a depth of up to 3 mm. The rest of the gum pocket is treated with curettage or ultrasound.

The operation of resection of the gum pockets is performed under local anesthesia. After excision of the "excess" of the gums, a gingival bandage is applied to it. When bleeding, swabs moistened with a 2% hydrogen peroxide solution are applied.

This operation leads to lengthening of the crown of the tooth - the tooth becomes visually longer, although, in fact, the zuyu does not increase.

What is the resection of gum pockets?

Resection of gum pockets is crucial moment in the treatment of periodontal diseases. Deep gum pockets are a reservoir for food particles and bacteria that are created there. favorable environment for development. The simple application of antibiotics without removing the gum pockets will not lead to success, as these pockets will again and again accumulate food particles, and therefore bacteria. Moreover, deep gum pockets make it difficult for both the patient and the dentist to clean the teeth from dental deposits.

It is worth noting that when gum pockets are removed, the exposed part of the teeth becomes more sensitive to hot or cold food.

Bone regeneration

The bone regeneration procedure is another surgical method for the treatment of periodontal tissue disease, in cases where bone resorption is noted. The essence of the bone tissue regeneration procedure is that a special protein is installed in the place where this bone tissue is damaged by a pathological process, which stimulates bone tissue regeneration.

The very procedure of bone tissue regeneration is carried out as follows. Under local anesthesia, the doctor makes an incision in the gum area. Then the resulting gum flap is “folded back”, after which the doctor cleans the bone from pathological tissues. For this, both curettage and ultrasonic cleaning can be used.

In addition to therapeutic purposes, bone tissue regeneration can also be performed for cosmetic reasons.

Currently, periodontists have several options in their arsenal for the regeneration of jaw bone tissue in periodontal disease: this is the use of special materials and proteins that stimulate the process of bone tissue synthesis. In the first case, after the extraction of the gum flap, a special material is installed around the tooth, which prevents the gum tissues from growing into this area, where the bone should be, as a result of which it is the bone tissue that is restored in this area. In another case, a special protein-based gel is used that stimulates bone growth.

Tooth crown lengthening

The procedure for lengthening the crown of the tooth does not consist in lengthening the tooth itself, but in lengthening the so-called clinical crown of the tooth - that part of it that is visible above the gum. This procedure is the opposite of soft tissue grafts. If during periodontal disease the teeth may look too long, due to the fact that the gum tissue, as it were, resolves, then with hypertrophic gingivitis, some teeth may look short, as gum tissue grows on them. To treat such a pathology, a small section of the gum is removed, due to which an elongation of the tooth crown appears.

The use of soft tissue grafts

As we have already said, with periodontitis and periodontal disease, resorption of periodontal tissues, including gums, can be noted. This leads to the exposure of the tooth tissue, up to its root, which manifests itself hypersensitivity teeth to cold and hot. The treatment for this problem is the use of soft tissue grafts. To do this, a piece of tissue is taken from the palate area, which is sutured to the affected area. This procedure helps to prevent further formation of a gum pocket, as well as to cover the tooth, which protects it from the development of caries. Such a procedure, in addition, can be carried out for cosmetic reasons.

This operation is performed if the development of periodontal disease has led to the exfoliation of the gums from the tooth. As a result of an advanced form of gingivitis, a gum pocket is formed - an excellent place for bacteria to multiply: food gets into the gap between the gum and the tooth, making the tissues even more loose and swollen. Gradually, the distance increases, a new space appears for the development of microbes, which again contributes to the further progression of the disease.

To stop the destructive process, the dentist excises the gum 3 mm deep. The rest of the tissue is treated with ultrasound. All manipulations are done under local anesthesia, after which a special bandage is placed on the gum. To stop possible bleeding, sometimes use tampons with hydrogen peroxide.

Bone restoration

If, as a result of periodontal disease, bone tissue has begun to dissolve, then it is necessary to restore it. To do this, a protein is installed in the damaged area of ​​\u200b\u200bthe bone, which stimulates regeneration. Process steps:

  • anesthesia;
  • cutting the gums and bending the resulting flap;
  • cleaning of bone tissue;
  • introduction of proteins latest generation for tissue repair.

This procedure can also be performed to improve aesthetics.

Crown augmentation

In this case, it is not the tooth itself that is lengthened, but its clinical crown- the part that is above the gum. The operation is simple and painless (performed under local anesthesia). After the procedure, the teeth become slightly longer.

Use of soft tissue grafts in the studioVSP-Dental»

If the tooth as a result of periodontal disease is exposed to the very root, then its sensitivity increases. To solve the problem, the dentist uses soft tissue grafts. To do this, he takes pieces of tissue from the sky and sews them to the affected area. As a result, the sensitivity of the tooth is reduced and the formation of a gum pocket stops.

All these operations can be done in the VSP-Dental studio. Your dentist will provide you with more details during a personal consultation. Contact us!

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