Surgical Periodontal Therapy
When gingivitis is allowed to progress, periodontal pocket depth increases, plaque and calculus continue to build up on root surfaces, and the underlying bone become damaged. This is called periodontitis, and it is a generally progressive, non-tender condition which is the most common cause of premature tooth loss in humans worldwide. Success of non-surgical periodontal treatment is dependent almost exclusively upon one factor. Accessibility to thoroughly debride (clean) the root surfaces, by the patient and the dental professional. If the root surfaces are not able to be thoroughly cleaned by scaling and root planing, it may become necessary to perform periodontal surgical therapy.
Debridement of contaminated root surfaces and regeneration of damaged supporting bone are the two goals of surgical periodontal therapy. These are generally accomplished simultaneously. Access to the root surfaces is accomplished by making the tissue numb, making an incision between the teeth, and gently reflecting a flap of soft tissue, exposing the underlying bone and tooth surfaces. A variety of instruments are used to debride the root surfaces and remove infected soft tissue from the bone defects. The roots are cleaned, and treated with an antibiotic solution to decontaminate them of any residual bacterial contaminants.
Osseous (bone) defects are generally grafted following debridement of the root surfaces. Bone graft materials can be synthetic, donor material from other humans or animals, or the patient’s own bone, harvested from adjacent sites. Synthetic materials generally are the least effective. Bone from other species has long been used, but due to concerns about disease transmission, they are not used in this practice. Human bone graft material, either from the surgical site, or nearby tissue, or donated human bone is generally most effective. Human bone graft material in our practice is sourced from only one tissue bank, Lifenet. I trust that their screening and processing results in a safe and biologically active material.
Osseous Periodontal Surgery is a very safe and effective method to control periodontal disease and restore lost tissue. Other types of surgical periodontal therapy may be appropriate in individual circumstances. Different periodontists may recommend different treatment modalities. Our practice philosophy is a regenerative philosophy. In most cases, it is best to attempt to arrest the progression of periodontal disease and regenerate lost tissue to the greatest extent possible.