Periodontal Surgery

• Restorative crown lengthening

When there’s gross missing of tooth structure and a crown is recommended to restore the tooth. sometimes depending on the height of remaining tooth structure, crown lengthening procedure might be needed to expose adequate tooth height to make the crown.  If the tooth has broken down to the gum line, crown lengthening procedure is used to expose more of the tooth by removing small amount of bone around the tooth and expose more of the tooth before making a crown.  

• Pocket reduction surgery

For patients with gum disease which means there are periodontal pockets measured at 4mm and deeper around the teeth, the first step of treatment is to scaling and root planning ( deep cleaning ) when the hygienists use special instruments to eliminate bacterial buildup above and inside the deep pockets on the root surfaces of teeth.  After the initial treatment, patients are put on the perio maintenance program where the teeth are cleaned and perio pockets are measured every 3 or 4 months.  If the pocket depths are not significantly reduced after a period of time of non-surgical perio treatment, which occurs especially for pocket depth of 5mm and deeper where even the professional instruments might not be able to effectively clean the root surfaces of the teeth,  pocket reduction surgery, surgical perio treatment, would be recommended to reduce the pocket depth and create shallow pockets so that the patients can keep the teeth clean at home and the hygienists can effectively clean the teeth at the maintenance program and control the gum disease.  

During the pocket reduction surgery, some of the excess gum tissue around the teeth will be removed and the diseased bone will be reshaped which often has irregular shape due to the destructive nature of the gum disease to the bone. This procedure will help restore the natural contour of the bone that exists in a healthy mouth and the gum will be placed downward ( apically ) toward the root surface and form a tight biologic seal around the teeth. In this way 5-8mm pockets can be turned into 3-4mm which you can keep clean at home. Another advantage to the surgery is that it allows complete access to the base of the pockets and the entire root surface so that the hygienist can clean these areas effectively during the perio maintenance program.  Patients who keep these areas clean and follow a strict periodontal maintenance recall program will have a highly successful rate for the treatment and control of the gum disease.

• Bone grafting and periodontal regeneration