Periodontics

What is it?
The treatment we carry out once a periodontal disease with loss of bone support has been detected is called RADICAL SCRAPPING AND SMOOTHING (also known as curing, although this is not the correct word). A hygienist and periodontist are involved.

Process
The process is usually done in two sessions. In the first session we perform a radiographic series and with local anesthesia we measure tooth by tooth all the periodontal pockets of the upper quadrant (periodontogram with electronic probe Florida), i.e. to define the distance between the edge of the gum and the bone level to assess the situation in which the patient is initially. Like this, we will be able to anticipate the individual prognosis of each tooth.
The scraping is also performed, using instruments called CURETTE. The tartar that is adhered to the root under the gum is removed with this instrument. Finally, we explain the patient how to carry out their hygiene at home and which instruments to use, since not every mouth needs the same techniques. This session usually lasts two hours.
The following session, which we recommend to perform in the same week or the week after the first one, exactly the same procedure is followed, but this time we work on the lower arch.
After a month and a half, we assess again the patient’s condition. We measure again the distance between the gum and the bone. Also, we check if the patient has the plaque under control at home after this time. It is the moment to evaluate if they need new hygiene instructions or to reinforce them, if they have not fulfilled these.
If the response to the treatment is good and there is no inflammation anymore, and bone defects have decreased, we will continue to the phase of PERIODONTAL MAINTENANCE. This is normally done every six months. Then we check again the status of the teeth and we scrape and plan with curettes the areas susceptible to continue inflaming or to be reservoirs of tartar under the gums. In this way, we anticipate the possible bone destruction that can occur. And in the case of a relapse, it allows us to make an early diagnosis of it and, therefore, reduce the sequelae it may have on the patient’s periodontium. Without a six-monthly maintenance program, patients tend to return to their previous levels of hygiene, showing signs of periodontal worsening and greater tooth destruction.
If, even after a correct treatment and hygiene at home, some localised bone defects persist which avoid to take under control the disease, it may be necessary to perform a PERIODONTAL SURGERY. With this, we remove the residual periodontal pockets by opening a flap with a scalpel and remodeling the gum and bone. Finally, it is sutured in a more favorable position for a good later maintenance

What is it?
If the gum is visible when smiling, then you have a gummy smile and it may be due to an altered passive eruption. This is an abnormality in the normal eruption process produced by excessive gum overlapping over the enamel limits which results in a short clinical crown appearance, as it remains covered.
It is an aesthetic alteration and can also cause functional and periodontal problems.

In order to correct it, a crown lengthening surgery is carried out to expose the anatomical crown of the tooth and to define the correct harmony between the gum and the teeth

Process
A gingivectomy is carried out and the collar of excessive gingiva is removed leaving the bone visible. Then, we are able to reshape it, and subsequently the gum is sutured with simple stitches.

The suture removal is performed two weeks after treatment. It is not usually necessary to prescribe any medication, just the application of a bioadhesive gel that facilitates healing and prevents infection of the wound.

What is it?
The gum plays an important role in supporting and protecting the teeth.
It can be damaged by many factors: inflammation, abrasive brushing, etc.
This causes gingival retraction and exposure of the root surfaces, which can generate discomfort or sensitivity in addition to the negative impact that this entails on the aesthetics of the patient

Process
The gum graft, also called periodontal plastic surgery, is a minimally invasive technique that consists of extracting the soft tissue, usually from the palate or tuberosity regions, to cover an exposed root or implant surface.
Depending on the degree of severity of the recession and the condition of the patient’s gums, the periodontist will determine which root covering technique is the most appropriate for the given case.
It is carried out in a session of approximately one and a half hours. A check-up is performed weekly and the suture removal takes place two weeks later.
The prescription of an antibiotic, anti-inflammatory and an antiseptic gel is necessary for good wound healing.