Periodontics

Bone Grafting

Bone grafting is advised when a patient does not have a sufficient amount of healthy natural bone for a placement of dental implant. These bone defects can be caused by any face injury, developmental defects or maybe due to gum disease. Bone grafts can be obtained in multiple ways. Usually, it is taken from patient’s own body. If there isn’t any additional bone then bone from a cadaver is used. When bone graft is harvested from person’s own body it is known as autograft and when it is taken from deceased donor it is called allograft.

Why you need bone grafting?

When a tooth is missing, jawbone begins to resorb. In such cases bone grafting can be done to stimulate bone growth. A bone graft can also be used in the case of injury or fracture.

Procedure

This procedure is performed under local anesthesia so that patient does not feel any pain. An incision is made in the gum to gain access to the bone beneath it, and then grafting material is added. After this, a protective liner is placed over top of the material, and the area is sutured back. Patients may experience mild discomfort for a few days.

Aftercare

It is important to follow all aftercare instructions to ensure a successful graft.

• Patient may experience soreness after surgery. It can be managed by anti-inflammatory medication prescribed by doctor.
• Recovery time depends on many factors. Eating a healthful diet and not smoking are essential for a good recovery.
• The swelling that is normally expected after grafting can be minimized with the use of ice pack.

Risk associated with bone grafting

Bone grafting is generally safe but it does have some rare risks like:

• nerve injury
• sinus problem
• infection
• bleeding, pain, swelling
• rejection of bone graft by the body

Periodontal Flap Surgery

Periodontal flap surgery is the most commonly used method for treatment of periodontal diseases i.e. gum diseases. Flap surgery is the leading method for treating periodontal pockets.

Goals of flap surgery

The main goal of flap surgery is to reduce the gum pockets. When periodontal pockets develop the first treatment option is scaling, if this does not work flap surgery is the best option. Another goal is the regeneration of gum and periodontal ligament.

Procedure

The surgery is done by applying local anesthesia to the infected area. Then the surgeon will make incision on gums to separate the gums from teeth. The gum tissue is folded back to access the root and surrounding bone tissue. Next, the diseased gum tissue is removed, and the tooth roots are cleaned. If any bone defects exists, it is treated by surgeon. After cleaning and repairing is over, the incision is closed and procedure is completed.

Recovery & aftercare

Recovery depends on many factors like overall health, severity of disease and type of surgery. For a week or two patients might not be able to brush in certain areas of the mouth. Patient may also experience mild discomfort for few days. Follow-up instructions should be followed carefully to ensure a quick recovery:

• Proper medication should be taken as prescribed.
• Rinsing with warm water should be done to reduce pain.
• In case of swelling ice pack should be applied.
• Proper oral care should be taken.
• Strenuous physical activity should be avoided.

Scaling and Root Planing

These are also known as non-surgical periodontal therapy. Scaling is done to remove plaque and tartar above and below the gum line. Plaque is a sticky film of bacteria that constantly forms on teeth, if they aren’t cleaned well; bacteria can cause gums to become inflamed. There are two basic methods for scaling:

Scaling with hand instruments

In this method, dentist uses a handheld scraping instrument to remove plaque and tartar from the teeth. These instruments are called dental scaler and curette.

Scaling with ultrasonic instruments

Ultrasonic scalers are used to remove calculus rapidly from the tooth surface. It features vibrating metal tip. The tip chips off the tartar as the water flushes out the pocket and keeps the tip cool.

Dental scaling is followed by a procedure known as root planing. Root planing removes the microbial flora on the root surface or lying free in the pocket. Root planing smoothes the surface of the root so the gums can reattach properly. Root planing smoothes rough areas on the root surface.

Benefits

Following are the benefits of scaling and root planning:

• It eliminates bad breath
• It lowers the risk of heart diseases
• It prevents gum disease and tooth loss
• Regular scaling prevents plaque accumulation under the gum line
• It is a painless procedure which means tartar and plaque are removed without any pain or discomfort

Aftercare

After root planing and scaling, patient may experience numbness, pain and sensitivity.

• Patient should get in the habit of using a mouthwash.
• Brushing is recommended twice a day with fluoride toothpaste.
• To prevent pain and infection, medication should be taken as prescribed by dentist.

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