Surgical & Laser

Initial Preparation

Initial preparation with scaling and root planning often produces shrinkage of the inflamed gum tissue and thus a reduction of the pocket depth. However, with pockets that continue to bleed when probed, or with pockets deeper than 5mm, there is a high probability the disease process will continue. In those cases, elimination of the remaining pockets is the best treatment. If it is obvious during the examination that surgery is needed to obtain the best result, parts of the Initial Preparation may be abbreviated. Scaling and root planning may be done during surgery. This approach avoids repeating steps of Initial Prep thus saving time and reducing costs.

Four Primary Surgical Procedures

There are four primary surgical procedures that may be used to reduce or eliminate pockets that remain after Initial Preparation. (Click any heading for a more detailed discussion and clinical examples.)

• Gingivectomy - Trimming excess tissue when the bone contour has not been altered.
• Flap Surgery - The most common surgical procedure, giving the periodontist access to the jawbone. In most advanced cases, the bone has been altered by infection and smoothing irregularities is needed.
• Tissue Regeneration - Bone Grafting - Ideally, periodontal therapy would regenerate bone and tissue back to its original form. While this is not always possible, new techniques are allowing for more Predictable regeneration of tissues.
• Perioscopy - Endoscopic dental surgery with a miniature digital video probe inserted into the pocket with minimal or no incision. This allows the doctor to see the tooth on a video monitor with up to 48 times magnification. Treatment can be done without conventional flap surgery. Results with this new technology is very promising and the healing time is 1 to 2 days.