Peridontal Treatment : Scaling, root planning Flap Surgery Done at patiala

		Periodontal disease is more commonly known as gum disease and was referred to as pyorrhea in the old days. It is a progressive inflammatory disease of the gingival and the surrounding tissue (bone) around the teeth. Periodontal disease is the number one cause of tooth loss after the age of 30 and it is believed that around 80% of the population above the age of 30 may suffer from this disease, with varying degrees of severity. It is usually painless and is mainly caused by plaque although pregnancy, diabetes, epilepsy, and such medications as chemotherapy, medication prescribed for heart problems, birth control pills, and antidepressants can all make you more susceptible to gingivitis which is one of the more common forms of periodontal disease.

There are many forms and stages of periodontal disease. The most common are: Gingivitis : The first stage of periodontal disease, gingivitis, is the mild inflammation of the gingival caused by plaque build up. Your gingival will be red, swollen, and tender. You may also notice bleeding while you brush and floss. This stage of periodontitis is reversible. Mild Periodontitis : Inflammation will spread to the supporting alveolar bone. Minor bone loss and the formation of periodontal pockets, or food traps, may occur. Moderate Periodontitis: In this stage, there will be increased gingival recession, moderate to deep pockets, moderate to severe bone loss, and mobility of teeth due to the bone loss. Severe Periodontitis : This is the most serious stage of periodontitis. Deep pockets, increased mobility of teeth, movement of teeth out of position, and visible fistulas (boils) will be present in this stage. Pus may develop; bone loss continues, and your teeth may loosen or fall out
Diagnosis: To diagnose periodontal disease, the doctor will evaluate several things: Color and condition of the gum line Pocket depth measurements Bone line as revealed by x-rays Mobility of teeth Amount of calculus These findings determine the periodontal stage and therefore determine the appropriate treatment plans.
Treatments Treatment will depend upon the type of periodontal disease and how far the condition has progressed. Non-Surgical Treatment Non-surgical treatments will be applied if the patient is still in the early stages of periodontal disease. Oral Hygiene If the disease is still in the first stage (gingivitis) your dentist may prescribe an anti-microbial mouth and advise you to brush and floss on a regular basis. Scaling and Root Planning Periodontal scaling is a treatment procedure which involves the instrumentation of the crown and root surfaces of the teeth. Plaque, calculus, and stains will be removed from these surfaces. It is performed on patients with periodontal disease and is therapeutic, as apposed to prophylactic and may precede root planning. This procedure can be used as a definitive treatment or as part of pre-surgical therapy ("tissue preparation") depending on how far the periodontal disease has advanced. Debriding the root surface is a critical element in establishing periodontal health
Bone or Gingival Augmentation Surgical augmentation treatments, along with non-surgical treatments, are performed when the periodontal disease has reached a more advanced stage. These include: Augmentation This is a surgical procedure which uses a barrier membrane and or bone graft replacement material placed under the gum and over the remaining bone support (ridge or jaw bone) to aid the regeneration of new bone in an area where teeth are being extracted or have already been removed. The graft material may be taken from the patient's own body (autogenous bone). If not, an artificial, synthetic, or natural substitute may be used. This prevents the surrounding bone from collapsing into the extraction socket after the removal of a tooth. If this procedure is not carried out, the ridge will become narrow and sharp and it will not be possible to insert an implant or a comfortable-fitting denture. Guided Tissue Regeneration This procedure is practiced in tandem with a surgical flap operation. Gum growth into a defect is cordoned and this allows slower growing bone, cementum and ligament cells to take its place.
Soft Tissue Grafts In cases of gum recession a graft is usually taken from the palate and transplanted onto the affected area. This reinforces the thin gum and makes it difficult for the gum to recede further and may even help to cover the exposed root. It may also reduce tooth sensitivity and even improve the esthetics of your smile. Bone Grafts Minute fragments of the patient's bone, synthetic bone or bone acquired from a bone bank are used to fill a bony defect around the teeth. These grafts act as a support for the original bone and will help it to grow.
Periodontal Regenerative Procedures A regenerative procedure is often recommended when the bone supporting your teeth has been destroyed. It is possible to reverse some of the damage by regenerating lost bone and tissue. The gum tissue is folded back and the bacterium which is causing the disease is removed. Membranes (filters), bone grafts or tissue-stimulating proteins can then be used to encourage your body's natural ability to regenerate bone and tissue. There are many methods which will enhance support for your teeth and help to restore your bone to a healthy level. The benefits of this procedure include the elimination of existing bacteria and the regeneration of bone and tissue which helps to reduce pocket depth and repairs much of the damage caused. Through daily oral hygiene and professional maintenance care, the chances of keeping your natural teeth will be increased. There will also be less chance contracting any of the serious health problems associated with periodontal disease.
Prevention The best way to prevent periodontal disease and tooth decay is to maintain good oral health care. Brushing your teeth every day will remove a thin sticky film of bacteria, called plaque that grows on your teeth. Cleaning between the teeth once a day with floss removes plaque from between the teeth - areas where the toothbrush can't reach. Brushing and flossing are essential in preventing gum disease. Brush your teeth twice a day, with a soft-bristled brush. Use a formula of toothpaste that contains fluoride, which helps protect your teeth from decay. It is also advisable to seek regular dental visits that include a periodontal evaluation. Pre- and Post-Operative Care In most cases, the gums are too tender to brush post-operatively. We will provide you with an antibacterial rinse called chlorhexidine which will chemically reach those areas that the tooth brush will be too sensitive to debride. Warm salt water will help to reduce gum inflammation and an antibiotic is usually prescribed to prevent infection. Analgesics (pain medication) can be used if the pain becomes severe. It is essential for your dentist to monitor your progress and a series of appointments will be scheduled at three month intervals. Dental Prophylaxis Treatment for the prevention of periodontal diseases or other dental diseases by the cleaning of the teeth in the dental office using the procedures of DENTAL SCALING and DENTAL POLISHING. The treatment may include plaque detection, removal of supra- and subgingival plaque and calculus, application of caries-preventing agents, checking of restorations and prostheses and correcting overhanging margins and proximal contours of restorations, and checking for signs of food impaction.
Crown Lengthening Scaling Scaling is procedure that meticulously removes contamination toxins, micro-organisms, plaque, tartar, cementum, dentin that is rough and/or permeated by calculus from around, below and under the gum line down to the bottom of the pocket. This is done to remove biofilm, calculus, and toxin down to the bottom of each periodontal pocket in order to obtain a healing response. Root Planning Root planing involves smoothing the root surfaces of your teeth with thin curettes so gum tissue can more firmly reattach to roots that are clean and smooth to prevent tooth loss and sensitivity problems. The procedure makes it more difficult for plaque to accumulate along the root surfaces. Because this procedure goes deeper than a regular cleaning, your mouth may be numbed. The cleaning may take two visits to complete. Depending on the extent of the disease you may need one or more sections (quadrants) of the mouth to be treated with scaling and root planning. Treatment may require one or more visits.
Gingival Curettage Gingival curettage removes the soft tissue lining of the periodontal pockets in order to completely eliminate bacteria and diseased tissue. It may be used along with scaling and root planning, but achieves a deeper and more complete cleaning. Evidence indicates, however, that it does not contribute any additional benefits beyond simple scaling and planning. Gingivectomy You may need surgery for severe gum disease (periodontitis) if it cannot be cured with antibiotics or root planing and scaling. A gingivectomy removes and reshapes loose, diseased gum tissue to get rid of pockets between the teeth and gums. A gum specialist (periodontist) or oral surgeon often will do the procedure. The Periodontis will start by numbing your gums with a local anesthetic. The Periodontis may use a laser to remove loose gum tissue. After removing the gum tissue, the doctor will put a temporary putty-like substance over your gum line. This will protect your gums while they heal. You can eat soft foods and drink cool or slightly warm liquids while the putty is in place and your gums are healing. Gingivoplasty Gingivoplasty is a procedure in which we surgically reshape and re-contour the gum tissue for cosmetic, physiological, or functional purposes. Gingivoplasty is the surgical reshaping of the outer surface of the gums and it's usually done in combination with gingivectomy. The term comes from gingiva meaning gums and the word ending -plasty meaning to reshape. Many patients have a gummy smile which is caused by excessive and overgrown gum tissue. Excess gum tissue can usually be removed to reveal a beautiful smile underneath. After a gingivectomy procedure, the gingivoplasty procedure thins the remaining gums tissue so the tissue looks natural and pleasing. It's done this using an electrosurgery unit and a specially designed electrical cutting tip. The electrosurgery unit uses electricity to cut the gum tissues and at the same time, causes the gum tissues to clot and stop bleeding. Gingivoplasty corrects the remaining thick and unnaturally shaped gum tissue left after the gingivectomy procedure exposes the hidden teeth. Natural gum tissue thins as it approaches and surrounds teeth. It can get confusing because the two procedures are almost always used at the same time. These procedures can also be used to reshape irregularly shaped and unattractive gums. Gingivoplasty procedures are usually done with local anaesthetics. The electrosurgery equipment minimizes bleeding and most patients experience very little post operative pain after the procedure.
Crown Lengthening Crown lengthening is used to keep the gums around a crown healthy. The gums drape around a tooth and protect the tooth and bone that holds the tooth in the mouth. The gums bond to the tooth surface and this bond prevents food from getting stuck between the tooth and gums. The gums need at least two millimeters of tooth to attach to in order to be effective in preventing food from trapping under the gums, otherwise serious problems can develop. Sometimes part of a tooth will crack off so that the 2 mm for the gums to bond is not available. Crown lengthening surgery is needed. Another reason that the needed 2 mm might not be available is when a tooth decays and after removing the decay, the dentist finds that there is less than 2 mm of tooth left above the bone. This procedure is used to recreate this needed amount of exposed tooth. The patient is numbed and an incision is made around the tooth needing crown lengthening. The gum tissue is gently peeled away from the tooth to show the supporting bone holding the tooth in place. Now the dentist can see that there is not two millimeters of tooth available to stick to. In the procedure the dentist removes several millimeters of bone around the tooth to expose the tooth that was previously underneath the bone. After the dentist is sure there is two millimeters or more of tooth sticking out of the bone, the gums are replaced and stitched carefully back in place. The surgery is now complete. The gums are allowed to heal six weeks and a crown can then be constructed, Sometimes a patient has a gummy smile that hides the beautiful teeth underneath the gums. This procedure can be used to shape the gums to create a more beautiful smile. In most cases the gums only need to be shaped enough to match the amount of teeth shown in that patient's smile.

Periodontics