Periodontal surgery is related to the diseases or abnormalities in the periodontal structures which support the teeth such as the tissue of gum, periodontal bone, and covering ligaments. Periodontal disease is an infection of the tissues which are holding your teeth firm. This article informs all about Gum Disease.


There are lots of ways to treat any disease but there is only one correct diagnosis that is important. Periodontal disease is detected when the dentist physically and visually examines gum tissues and finds out the abnormalities in the teeth through dental radiographs.

All these help to diagnose the disease properly and give the proper treatment. Diagnosis may also include risk assessment and durability of the given treatment to the patient.

Causes of Periodontal Diseases :

The cause of this disease is hidden in poor oral hygiene. This disease Particularly caused by unusual habits of brushing and flossing that allow a sticky cover of Bacteria that is called Plaque to build up on teeth and harden. Our mouth is full of bacteria. These bacteria and mucus with other particles present in the mouth together forms a sticky, colorless plaque on teeth. Smoking, chewing tobacco, and other such additions are also responsible for the decay of gums and teeth. It can be cleaned with daily brushing and flossing but due to poor brushing sometimes it is not cleaned properly and saturates on teeth for several periods of time which is hard to clean easily. It can’t be cleaned by simple brushing, it needs a visit to the dentist or any dental hygienist to get rid of the plaque. 

Symptoms of Periodontal Disease :

The bad smell while breathing

Pain during chewing something

Loose teeth 

Swollen, red and bleeding gums with pain 

Deep gaps formed between teeth and your gums

There are some non surgery treatments available for the periodontal disease such as scaling and root planing .In this treatment carefully root surface is cleaned to remove plaque.Dentist opines that sometimes with the help of this treatment patient get rid of the problem .After treatment also if patient will change the habits of brushing and flossing definitely they can maintain the health of gums and teeth. But in some cases dentists suggest the need for surgery. 

In advanced stages, Periodontal disease can result in sore, bleeding gums, pain while chewing something, and also tooth loss due to loose gums. If you are suffering from severe gum infection, your dentist will recommend surgery. This surgery will help to :

Clean bacteria spread beneath your gums

Clean your teeth to free it from plaque

Rebuild the shape of bones which support your teeth to avoid the bacterial growth in it 

Regrow the damaged tissues in gums

Prevent gum abnormalities and damage in the rest of your life. 

Remove bacteria and infections

After checking out the symptoms and condition of your gums your dentist will recommend the proper treatment to get rid of this problem.

Initial Preparation Sets the Stage for Surgery

Behavior Change: Consistent behavior change is the most important element in maintaining long-term periodontal health since daily plaque removal in large part will set the stage for sustained, successful surgical treatment. For many people, this involves forming new oral hygiene habits, along with the cessation of smoking and other lifestyle changes.

Calculus (Tartar) Removal: Your dentist will also see that your teeth receive a thorough cleaning to remove the deposits of calcified plaque called calculus or tartar and other bacterial toxins that become ingrained into the root surfaces. This process of mechanical cleaning is generally known as scaling and root planing, using hand scaling, ultrasonic or laser instruments and will sometimes require local anesthesia.

Occlusal Bite Therapy: Generally, attention to the bite or bite disorders are treated during or after initial therapy once an inflammation free environment has been established. It is important to stabilize loose teeth prior to surgery because this in itself encourages healing of the periodontal structures and bone.

Preparatory stages in this Surgery:

Behavior change is important to maintain long term teeth health. Improvement in the brushing habit is important and also avoids the addiction such as consuming alcohol and smoking.

The dentist will try to clean the tartar on your teeth thoroughly. This mechanical process is called scaling and root planing. Sometimes it needs local anesthesia also .It is dined with hand scaling, ultrasonic, or laser instruments.

It is important to fix the loose teeth before surgery as it encourages the early healing of periodontal structure and bone.

At least a week before the procedure the patient should stop taking certain medicines like aspirin, pain relievers, and blood thinners. Most of the dentists also advise to avoid smoking or drinking alcohol minimum 24 hours prior to the procedure.

The dentist prescribed antibiotics to take before the surgery to slow down the growth of infection.

There must be someone with a patient to take him home after surgery. The anesthesia patient will receive during surgery might affect body control. That means it may be dangerous to drive after the procedure.

The patient follows the instructions given by the doctor before the procedure.


The dentist operates the gums. There are various types of surgical procedures. Your doctor will decide what type of surgery is suitable to treat your disease.

Flap surgery

This is a very common surgery, the surgeon makes small cuts in gums and lifts a section of tissue back. Then they clean tartar and bacteria from the tooth and from beneath the gums. The gums are tightened back so the tissues fit strongly around the teeth. Once it will heal it will be easy to clean the gums and teeth.

Bone grafting

Bone grafting means if gum disease has damaged the bone around the tooth root, dentists have to replace it with a graft. Graft means living tissue. The bone graft can be made out of your own bone or donated bone. This procedure helps to prevent tooth decay and helps the natural growth of the bone.

Guided tissue regeneration

This method involves placing a small piece of material between your bone and gum tissue to allow the bone to regrow.

Soft tissue grafts

In this treatment, the graft is useful to restore some of the tissue which is lost. Dentists remove some tissues from the other part of your mouth or use donated tissue to attach to the areas where tissue is missing.


Sometimes, surgeons apply a gel to the diseased tooth root that contains special proteins. This can encourage healthy bone and tissue growth. 

Images Before and After Surgery :

Risks, Benefits, and Alternatives

It is important to have a discussion with your periodontist or general dentist to educate yourself regarding the risks, benefits, and alternatives before undergoing treatment as this treatment is not a complete cure . It increases the life of gums and teeth.

   The specific procedure you need should be discussed so you can understand what are the important stages of treatment. It should include what is the outcome of the surgery; generally mild to moderate discomfort for a day or two, usually managed by non-steroidal anti-inflammatory and analgesic medication of the Ibuprofen or Celebrex family, antibiotics, and antibacterial rinses.

  The forceful activity should be avoided for the first few days to ensure that bleeding does not occur. It is also likely that the teeth will be somewhat more sensitive to cold which will disappear over time, particularly with the application of fluoride varnishes.

·     What are the benefits and likely outcomes of treatment including a determination of development — what will be the expected result and how long they will last means time taken to be normal.

·     What are the alternatives to surgical treatment; this will depend upon the type and the extent of periodontal disease you have and the procedure that is recommended.

These issues will differ somewhat depending upon the type of periodontal surgical procedures. This process is called informed consent, and you will probably be asked to acknowledge this process in writing. It is part of the procedure.

Innovations in Regeneration

In the last few decades, there are advanced techniques emerged to regenerate periodontal tissues. Till the 1980s surgery was done to remove affected tissues only . Afterward grafting technique was used in this surgery. However regenerating technique is less predictable. 

Regenerating Periodontal Tissues

It is known as a part of tissue engineering also.Periodontal regenerating is a complete healing of the tissue.This technique was introduced in this field in 1993.

The periodontal ligament is a thin, fibrous ligament that connects the tooth root to the bony socket. Normally, teeth do not contact the bone directly; a tooth is suspended in its bony socket by the periodontal ligament which is attached to the tooth root via cementum.

Without new periodontal ligament formation, new attachment and bone regeneration are impossible. In the past, the difficulty had been stopping gum tissue cells growing down the freshly cleaned roots before the new periodontal ligament cells had a chance to grow and reattach to the root surface cementum. Stopping the gum tissue cells from advancing was the race that science needed to win in order to regenerate new periodontal attachment.

Guided Tissue Regeneration

This treatment goals at regenerating jaw bone in the situation when the implant is not possible.This concept was first introduced in 1976.Periodontal tissue regeneration was ingeniously solved with the advent of subgingival (sub-under, gingival-gum) “barrier membranes,” sort of minute subterranean band-aids. These barriers stop the growth of gum tissue cells and allow regeneration of new periodontal ligament by guiding cell growth. This technique is known as “Guided Tissue Regeneration.” Membrane technology has now advanced to the point where membranes will last exactly the appropriate amount of time needed for healing and then dissolve so that they don’t have to be removed.

Growth Factors — Magic Molecules

Most recently, basic science has further discloses wound healing with an understanding of growth factors. The process of inflammation, the body’s response to injury and infection causes the attraction of particular cells and liberation of their components, so-called growth factors — “magic molecules” which initiate and promote wound healing. The ability to isolate these substances, determine their roles, and then to be able to manufacture them has allowed periodontal and other surgical specialists to use growth factors to regenerate tissues, making results more predictable and healing uneventful.


Today’s smart and meticulous surgical techniques allow the periodontal surgeon to revive and reshape lost and lost tissues. Modern procedures are kinder to the patients; are carried out with local anesthesia (numbing the area/s) in combination with either oral (anti-anxiety) sedation or intravenous conscious sedation (twilight sleep). There are minimal post-surgical issues, minimal discomfort, and little bleeding, either during or after surgery. Periodontal surgery includes elements of art, experience, and a great deal of scientific knowledge of techniques and wound healing to prolong the life of your teeth with greater predictability than ever before. Periodontal surgery is called a blend of science with art.

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