Gingivectomy is a dental procedure in which a dentist or oral surgeon cuts away part of the gums in the mouth (the gingiva). It is the oldest surgical approach in periodontal therapy and is usually done for improvement of aesthetics or prognosis of teeth. By removing the pocket wall, gingivectomy provides visibility and accessibility for complete calculus removal and thorough smoothing of the roots, creating a favorable environment for gingival healing and restoration of a physiologic gingival contour. A common aesthetic reason for gingivectomy is a gummy smile due to gingival overgrowth.
An alveoloplasty is a surgical procedure that reshapes and smoothes out the jaw where a tooth or teeth have been extracted or lost. The part of the jawbone that houses the teeth is called the alveolus, and “plasty” means molding, so alveoloplasty is the process of molding or reshaping the jaw. Why would someone need this procedure? When a tooth is extracted, the socket (the hole where the tooth was located) heals over the course of several weeks. However, once healed, the area may not be ready for a tooth replacement, such as a denture, bridge or implant. The healed area is called an edentulous ridge, and it may be uneven or bumpy, which will not allow for a nice fit of the replacement tooth or teeth. Smoothing out the jawbone prepares the mouth for successful placement of the new, artificial tooth.
Flabby ridge is a common clinical finding affecting the alveolar ridges of the mandibular or maxillary arches. The anterior region of maxilla is the most affected area in edentulous patients. Dentures on flabby ridges have compromised stability, support, and retention unless adequate measures for its management are employed. Methods applied for flabby ridge management, include surgical removal and augmentation, special impression techniques, balanced distribution of occlusal loads and implant therapy. Special impressions often involve window technique for static impression of flabby area, which present multiple challenges.
Everyone experiences some form of plaque buildup. The saliva, bacteria, and proteins in your mouth form a thin layer that covers your teeth at almost all times. When you eat, tiny particles, acids, and sugars from the food stick to this film, creating a buildup on the teeth known as plaque. The bacteria that lives in this plaque can cause gum disease and tooth decay. Brushing, flossing, and regular dental cleanings will help remove the plaque and prevent more serious problems. If you have healthy gums, the tissue will fit tightly around the tooth and keep plaque out. However, if gum disease begins to form, this tissue will loosen. Healthy gums attach to the tooth just 1 to 3 millimeters below the gumline. With gum disease, you’ll begin to develop deeper pockets. These can fill with plaque, worsening your problems and causing symptoms like bad breath. Dental scaling involves the careful removal of plaque bacteria from the tooth’s surface just below the gumline. There are two basic methods for scaling teeth. If your dentist uses handheld instruments, he or she will scrape plaque from the tooth using a metal tool known as a dental scaler and curette. The dentist will insert this thin tool beneath the gum line to access plaque your toothbrush can’t reach.
Alternately, your dentist may choose an ultrasonic instrument to scale your teeth. This features a vibrating metal tip combined with a cool water spray. The tip chips tartar away as the water flushes out the pocket.
You may need surgery for severe gum disease (periodontitis) if it cannot be cured with antibiotics or root planing and scaling. A flap procedure cleans the roots of a tooth and repairs bone damage caused by gum disease. A gum specialist (periodontist) often performs the procedure. Before the procedure, you will be given a local anesthetic to numb (freeze) the area where the doctor will work on your gums. The doctor will pull back a section of your gums to clean the roots of your teeth and repair damaged bone, if needed. The gum flap will be sewn back into place and covered with gauze to stop the bleeding.
