Surgical Periodontics

Osseous Surgery

Traditionally, gum disease is treated by eliminating the gum pockets. The infected gum tissue is trimmed away and uneven bone tissue re-contoured. Although this is still an effective way of treating gum disease, new and more sophisticated procedures are used routinely today.

Gum Grafting | Crown Lengthening | Bone Regeneration | Cosmetic Surgery

Gum Grafting

Before photo of patient needing gum graft

After photo of patient with grafted gum tissue

Before and After Gum Grafting

When recession of the gingiva occurs, the body loses a natural defense against both bacterial penetration and trauma. When gum recession is a problem, gum reconstruction using grafting techniques is an option.

Gum Grafting Overview

For a brief narrated overview of the gum grafting process, please click the image below. It will launch our flash educational MiniModule in a separate window that may answer some of your questions about gum grafting.

Gum Grafting Overview

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When there is only minor recession, some healthy gingiva often remains and protects the tooth, so that no treatment other than modifying home care practices is necessary. However, when recession reaches the mucosa, the first line of defense against bacterial penetration is lost.

In addition, gum recession often results in root sensitivity to hot and cold foods as well as an unsightly appearance of the gum and tooth. When significant, gum recession can predispose to worsening recession and expose the root surface, which is softer than enamel, leading to root caries and root gouging.

A gingival graft is designed to solve these problems. A thin piece of tissue is taken from the roof of the mouth or gently moved over from adjacent areas to provide a stable band of attached gingiva around the tooth. The gingival graft may be placed in such a way as to cover the exposed portion of the root.

The gingival graft procedure is highly predictable and results in a stable, healthy band of attached tissue around the tooth.

Crown Lengthening

Crown lengthening (or crown exposure) is required when your tooth needs a new crown or other restoration.The edge of that restoration is deep below the gum tissue and not accessible.It is also usually too close to the bone or below the bone.

The procedure involves adjusting the level of the gum tissue and bone around the tooth in question to create a new gum-to–tooth relationship. This allows us to reach the edge of the restoration, ensuring a proper fit to the tooth. It should also provide enough tooth structure so the new restoration will not come loose in the future.This allows you to clean the edge of the restoration when you brush and floss to prevent decay and gum disease.The procedure takes approximately one hour.

When the procedure is completed, sutures, and a protective bandage are placed to help secure the new gum-to-tooth relationship.You will need to be seen in one or two weeks to remove the sutures and evaluate your healing.

Guided Tissue Bone Regeneration

Traditionally, eliminating the gum pockets by trimming away the infected gum tissue and by re-contouring the uneven bone tissue treats gum disease. Although this is still an effective way of treating gum disease, new and more sophisticated procedures are used routinely today.

Guided tissue bone regeneration regenerates the previously lost gum and bone tissue. The bone added to these defects is usually obtained from a tissue bank or from your own bone. Most techniques utilize special membranes that are inserted over the bone defects to encourage bone and tissue regeneration. Some of these membranes are bio-absorbable and some require removal. Other regenerative procedures involve the use of bioactive gels.

Cosmetic Periodontal Surgery

These procedures are a predictable way to cover unsightly, sensitive, or exposed root surfaces and to prevent future gum recession. If you are unhappy with the appearance of short unsightly teeth this can be greatly improved by a combination of periodontal procedures and cosmetic dentistry by Dr. Graef or Dr. Richardson.

Although your teeth appear short, they may actually be the proper length. The teeth may be covered with too much gum tissue. We can correct this by performing the periodontal plastic surgery procedure, crown lengthening.

During this procedure, excess gum and bone tissue are reshaped to expose more of the natural tooth. This can be done to more than one tooth, to even your gum line, and to create a beautiful smile.

Another cosmetic procedure is the soft tissue graft. It is used to cover unattractive tooth roots, reduce gum recession, and protect the roots from decay and eventual loss.

Tooth loss causes the jaw bone to recede and can lead to an unnatural looking indentation in your gums and jaw, an appearance of a general aging. The original look of your mouth may not be recaptured because of spaces remaining under and between replacement teeth. They may appear too long compared to nearby teeth.

Bone grafting following tooth loss can preserve the socket/ridge and minimize gum and bone collapse. There is less shrinkage and a more aesthetic tooth replacement for either an implant crown or fixed bridge around the replacement teeth.

For more information about Periodontal Surgical Procedures, or to schedule an appointment, please call our office: 248-589-2021.