Surgical treatment of periodontitis

Surgical treatment is indicated if there are pockets >5 mm deep around teeth and gums bleed in these spots. To avoid spread of the disease, surgical correction is important in these areas.  

There are several surgical treatment methods:

Modified Widman Flap (MWF). During this procedure, gingival incisions are made to achieve a better exposure of teeth surfaces for more effective cleaning. The gums are then sutured without correcting osseous defects. These defects may later cause a situation where pockets form around the teeth again.

Apically Repositioned Flap. A similar procedure as above is performed to achieve better cleaning but osseous defects are also corrected. This procedure is more aggressive compared to the previous but the result is better because the pockets are removed.

Surgical treatment of periodontitis:

The attachment apparatus of a tooth is inflammatory and partially destroyed:

After gingival incision, plaque and tartar are removed:

 

Osseous defects are planed:

 

The opened gum is closed with sutures:

 

Regenerative surgery. During this procedure, we try to recreate bone that has been lost due to inflammation. This is a complex procedure that often requires using bone replacements, membranes and bone grafts. Unfortunately, this technique can be applied to treat specific vertical bone defects and it does not suit to correct even bone loss. However, in case of these specific defects we can save teeth that at first seem to have a hopeless prognosis. For this type of procedure to be successful, cooperation with the patient must be very good. This requires following very good hygiene practices at home and strict follow-up checks.  

Vertical bone defect:

 

Bone graft and membrane:

 

Fixing the membrane:

 

Primary closure of the gingival flap:

 

Mucogingival surgery. This type of surgery techniques are intended for correcting soft tissue defects. This includes covering receding gums, enlarging the attached gum mass and correcting gum defects/craters.