As you may have learned from our previous blog post, periodontal surgery is an advanced treatment often prescribed for severe cases of periodontal gum disease. Now that you know how and why it is done as well as what the expected outcome is, we will now discuss in more detail the different types of periodontal surgery. Periodontal surgery comprises several sophisticated procedures. The three primary classifications are gingival surgery, mucogingival surgery, and osseous surgery.
Gingival surgery, which most patients pertain to as gum lift surgery, is periodontal surgery performed to re-contour the gums with the goal being to improve the appearance of a smile. It includes gingivoplasty and gingivectomy. These two are different procedures often referred to interchangeably because they are basically the same procedure – but with different objectives.
In gingivoplasty, the gum tissue is re-contoured in order to eliminate diseased soft tissue from the wall of a periodontal pocket. Gingivectomy, on the other hand, is done to re-contour gingiva that has lost its normal form. It involves removal not just of the diseased tissue, but the entire portion of the gum tissue. It is often performed to correct a gummy smile, remove excess tissue from enlarged gums (i.e. gingival hyperplasia), or to lengthen the crown of a tooth that will receive a restoration.
Mucogingival surgery is a more complicated type of periodontal surgery. It is usually indicated for cases of advanced periodontal gum disease, particularly when there is a need to cover denuded root surfaces. It is also recommended for removable denture patients, mainly to deepen the oral vestibule and relocate free. The oral vestibule is the space bounded by the lip/cheeks and teeth. While frena (singular: frenum) is a small band of tissue in the lip and cheek area. A good example would be the maxillary labial frenum found underneath your upper lip. Above where the two upper central incisors meet. Increasing the depth of the oral vestibule will help improve retention of the removable denture. Relocating frena prevents dislodgement of the prosthesis.
Mucogingival is further divided into several techniques and these include the apically-repositioned flap, replaced flap, laterally-repositioned flap, free gingival graft, and frenum repositioning.
Last but not least, osseous surgery like mucogingival surgery is a form of advanced periodontal disease treatment that focuses on the management of the destruction caused by periodontal gum disease. As the name suggests, it involves manipulation of the bone tissue, particularly reshaping or restoring its ideal form based on the assumption that resolution of periodontal gum disease will occur if the bone and gums have the same contour.
Osseous surgery also has subtypes, namely bone reshaping/resectioning procedures and bone stimulative procedures. Bone reshaping procedures include osteotomy and ostectomy, which are indicated for correcting bone defects and creating normal bone contours. Osteotomy is reshaping without the need to remove bone, while ostectomy requires the removal of some bone. Bone stimulative surgeries, meanwhile, include bone grafts and implantation procedures. They help stimulate the body’s natural healing process to repair bone defects. And bring the bone back to its normal state.
Periodontal surgery, like any other surgical procedures, must be performed by a dentist. They are advanced training in the techniques discussed above. If you are planning to undergo any of the operations. Be sure to go only to a trusted dentist like Dr. Safarian, a San Diego dentist who has lots of experience particularly in gum lift surgeries.