Topics:
Periodontal (Gum) Disease:
Gum surgery
If you know you need gum surgery don’t worry because it sounds worse than it really is.
There are several types of gum surgery that we would recommend to you depending primarily on the condition of your teeth and gums. No matter which one you do, leave it to our specialists. With their knowledge, competence and manual skills, you can expect the desired therapeutic results.
There are many gum surgeries, some of which are used for aesthetic or health purposes.
The most common, however, are those that are part of the treatment of periodontitis. Then we always start with non-surgical treatment (cleaning and curettage of teeth) and, if necessary, we include surgical interventions.
Flap surgery
In periodontal surgery, one of the basic and most frequently performed procedures is flap surgery. It is performed in advanced stages of periodontitis, when non-surgical methods of treatment can no longer give adequate results. It is very important to follow the protocol in the treatment, i.e. to carry out the basic therapy beforehand, and only after that the gum surgery, and only in the places where it is necessary. Flap surgery can be performed on one, two or more teeth, and sometimes on all teeth of the upper and lower jaw.
The flap surgery aims at deep cleaning of limescale, elimination of deep pockets and creating conditions for easier maintenance of hygiene. It involves lifting the gums, removing deposits and rounding the bones if necessary. The gums return to a slightly different position in order to eliminate deep pockets and later make it easier to clean the teeth.
If necessary, flap surgery can be accompanied by the implementation of a bone substitute at the sites of bone defects.
It is performed under local anesthesia and is an absolutely painless procedure. The postoperative course is simple, there is no more pronounced pain or swelling.
In relation to the place of “return” of raised gums, we distinguish between apically and coronally displaced flaps and each of these gum operations has its own goal and purpose.
Flap surgery can be combined with orthodontic or prosthetic therapy. It is not uncommon for a person to have an irregular or bent tooth position, which causes the accumulation of bacteria and plaque and the formation of a periodontal pocket. In such and similar situations, we combine orthodontic therapy and gum surgery. Our specialists will, based on an individual therapy plan, give you a suggestion on when to have gum surgery.
Flap surgery is absolutely essential for people who have advanced periodontitis and want crowns to beautify their smile. Without adequate prior treatment and stabilization of the gums, it is not logical to expect later good aesthetic results.
Whether it is necessary to perform gum surgery for health or aesthetic reasons, flap surgery has its own ways and conditions of use.
Gum surgery – soft tissue grafts
If you have a gum recession problem this is one way to treat such a defect. It is crucial to first find the cause of gum recession and only then approach the intervention. The goal of this intervention is to “move” the tissue from one place in the mouth to another where it is needed. Gum surgery is also performed on too thin gums, which have a tendency to recede, even in places where the roots of the teeth are already exposed.
There are several types of gum surgery and the most commonly used are connective tissue grafts (TVT), free mucogingival autografts (SMAT) and pedicular grafts.
TVT – connective tissue grafts are most often used to cover exposed tooth roots. It involves taking connective tissue from the hard palate to cover the exposed root of the tooth with special techniques.
SMAT – free mucogingival autograft is another standard procedure. Tissue (but this time epithelial) is also taken from the palate and covers part of the surface on the gums.
Pedicure flap is a gum operation in which the donor site is also the palate. In this procedure, the tissue always remains attached to its base at one end, thus providing good blood circulation. For this reason, these interventions, provided they can be performed, are generally the most successful.
Gummy smile
If your gums are “lowered” or too visible during laughter and your teeth look short, now is the time to do something about it. Depending on the cause of this phenomenon, there are different solutions. Therapeutic procedures range from the simplest gum contouring, through bone tissue surgery to orthodontic bone repositioning therapy.
Contact us, our specialists in the mentioned areas will help you make the right decision for you. Not all situations or all patients are the same, and there is no universal therapeutic recommendation for a gummy smile. You need to know that this is not only a cosmetic but also a health procedure. It starts with analyzing the smile and seeing the desired contour of the gums and teeth. X-ray diagnostics and clinical examination will further direct the course of therapy.
Is it necessary to correct the gummy smile?
In most cases, gummy smiles are not corrected for health but for aesthetic reasons. However, if you have pain, frequent gingivitis or other disorders – correction is needed to eliminate health problems.
Gum contouring as a health procedure can be done by reducing periodontal pockets, lengthening the clinical crown of the tooth or covering the exposed neck of the tooth.
What causes gummy smile?
There are a number of reasons why gummy smiles can occur. It is linked to genetic origin or develops over a lifetime due to the use of certain drugs.
Gummy smile often occurs as a result of improper development of the jaw bones and improper tooth position. Today ‘s science pays more and more attention to the causal connection between the poor position of the cervical spine, which causes improper growth of the jaws, and the appearance of a gummy smile. Such a gummy smile can appear along the entire upper jaw, bilaterally and symmetrically, or in the form of too visible gums on only one side. Rarely, but it is possible that everything is fine with the teeth and jaws, but that the gummy smile appeared due to a short upper lip.
In children, gummy smile is not uncommon and is one of the first signs that the jaw bones are not developing in the right direction and that orthodontic therapy and / or myofunctional exercises are needed.
Gummy smile is common in both adolescents and children during and due to teething. During this period, periodontal treatment measures are not taken until the teeth are completely erupted.
How is gummy smile treated?
For the success of the treatment, it is necessary to first determine and eliminate the causes of the problem. Our specialists will, after reviewing and analyzing the images, determine the nature of the problem and accordingly suggest a possible therapy.
If the gummy smile is caused by enlarged gums, either due to inflammation or the use of medication, it is often enough to eliminate the cause, after which the gums return to their normal state. Then no further surgical correction is needed or it is enough in the form of minimal “cutting” and shaping of the gums – gingivectomy.
In order to correct the gummy smile that is a consequence of the growth of the jaw bones, it is necessary to contour the bones. The operation itself is done after estimating the length of the tooth roots so that they would not be weakened after the intervention.
One of the options that definitely comes into consideration is changing the position of the teeth and bones in an orthodontic way.