Periodontal Surgery

Periodontal surgery encompasses a range of procedures, including gingival curettage, gingivoplasty, flap approach surgery, and various grafting techniques. These procedures aim to remove infected tissue, promote tissue regeneration, and reconstruct damaged structures to restore both function and aesthetics. The type of surgery required depends on the severity and extent of the periodontal disease and the patient’s overall oral health.

Candidate

Who needs Periodontal Surgery?

Periodontal surgery may be necessary for individuals who have advanced periodontal disease or specific gum and bone conditions that cannot be effectively managed through nonsurgical treatments alone. Patients who may need periodontal surgery include those with:

• Severe gum inflammation or infection that has not responded to nonsurgical treatments, such as scaling and root planing or antibiotic therapy.
• Deep periodontal pockets that cannot be adequately cleaned through regular dental cleanings or nonsurgical procedures.
• Advanced gum recession, leading to exposed tooth roots and increased sensitivity.
• Significant bone loss or damage around the teeth, affecting the stability of the teeth and increasing the risk of tooth loss.
• Aesthetic concerns related to the appearance of their gums or teeth, such as uneven gum lines or elongated teeth due to gum recession.

Overall, a dental professional will determine if periodontal surgery is necessary based on a thorough evaluation of the patient’s oral health, the severity of their periodontal disease, and their response to nonsurgical treatments.

Nonsurgical Treatment

What are nonsurgical treatments?

Nonsurgical treatments are conservative approaches to managing periodontal disease without the need for invasive surgical procedures. These treatments aim to control the infection, reduce inflammation, and prevent further progression of gum disease. Some common nonsurgical treatments for periodontal disease include:

1. Dental Cleanings

   Regular professional dental cleanings help remove plaque and tartar deposits from the teeth and gums, reducing the risk of gum inflammation and infection.

2. Scaling and Root Planing

   Also known as deep cleaning, this procedure involves removing plaque and tartar from the tooth surfaces and root surfaces below the gumline. The root surfaces are then smoothed to help the gums reattach to the teeth and reduce the depth of periodontal pockets.

3. Antibiotics

   Topical or systemic antibiotics may be prescribed to help control bacterial infection and reduce inflammation in the gums. Topical antibiotics are applied directly to the gums, while systemic antibiotics are taken orally.

4. Antimicrobial Mouthwashes

   Prescription-strength antimicrobial mouthwashes can help reduce plaque and gingivitis by killing bacteria and inhibiting their growth.

5. Patient Education and Oral Hygiene Instruction

   Dental professionals will educate patients on the importance of good oral hygiene and provide instructions on proper brushing and flossing techniques to help maintain gum health and prevent further disease progression.

While nonsurgical treatments can be effective in managing the early stages of periodontal disease, more advanced cases may require surgical intervention to restore and maintain the health of the periodontal tissues.

Surgical Treatment

What are surgical treatments?

Surgical treatments for periodontal disease involve more invasive procedures to address advanced gum disease, restore damaged tissues, and prevent tooth loss. These treatments aim to eliminate the infection, regenerate lost gum and bone tissue, and improve the overall oral health of the patient. Some common surgical treatments for periodontal disease include:

1. Gingival Curettage

   This procedure involves the removal of infected gum tissue lining the periodontal pockets to promote healing and attachment of healthy gum tissue to the tooth surfaces.

2. Gingivoplasty

   A surgical reshaping of the gum tissue to improve its appearance or function, often performed in conjunction with other periodontal surgeries.

3. Flap Approach Surgery

   Also known as periodontal flap surgery or osseous surgery, this procedure involves lifting the gum tissue to gain access to the underlying bone and periodontal ligament. The dentist or periodontist cleans the root surfaces, reshapes the bone, and repositions the gum tissue to reduce pocket depth and promote healing.

4. Soft Tissue Grafts

   These grafts involve the transplantation of gum tissue from one area of the mouth to another to cover exposed tooth roots, treat gum recession, and improve gum aesthetics.

5. Hard Tissue Grafts

   Also known as bone grafts, these procedures involve the placement of bone or bone substitutes to regenerate lost bone tissue and provide support for the teeth.

6. Combination of Hard and Soft Tissue Grafts

   Also known as bone grafts, these procedures involve the placement of bone or bone substitutes to regenerate lost bone tissue and provide support for the teeth.

7. Guided Tissue Regeneration (GTR)

   This procedure involves the use of barrier membranes to promote the regeneration of gum and bone tissue in areas affected by periodontal disease.

Each surgical treatment option addresses specific issues related to periodontal disease and may be used in combination with other treatments to achieve the best possible outcome. A dental professional will determine the most appropriate course of treatment based on the patient’s oral health, the severity of the disease, and their response to nonsurgical treatments.

Preparation

Before undergoing periodontal surgery, patients should take several steps to ensure a successful procedure and a smooth recovery. Here are some essential aspects of preparation for periodontal surgery:

• Dental Evaluation and Treatment Planning

  Consult with your dentist or periodontist to discuss your specific needs, the type of surgery required, and the expected outcome. The dental professional will evaluate your oral health, review your medical history, and may take dental X-rays to develop a comprehensive treatment plan.

• Medical History and Medications

  Inform your dental professional about any pre-existing medical conditions and medications you are taking, including over-the-counter drugs, supplements, and herbal remedies. Some medications, such as blood thinners or immunosuppressants, may need to be adjusted or temporarily discontinued before the surgery.

• Oral Hygiene

  Maintain proper oral hygiene leading up to the surgery, including regular brushing, flossing, and using an antimicrobial mouthwash. Good oral hygiene can help reduce the risk of postoperative infection and promote a successful outcome.

• Preoperative Instructions

  Follow any preoperative instructions provided by your dental professional, such as fasting guidelines, smoking cessation, and alcohol restrictions. Adhering to these instructions can help ensure a safe and effective procedure.

Cost

How much do periodontal surgery procedures cost in Ontario?

The cost of periodontal surgery varies depending on the procedure, the extent of the treatment, and the dentist’s experience. Please note that the costs provided below are approximate and it is essential to consult with your dental professional to determine the best course of treatment and receive an accurate cost estimate for your specific needs.

In Ontario, nonsurgical treatments like scaling and root planing may cost between CAD $250 and $450 per quadrant. Surgical treatments like soft tissue grafts can range from CAD $800 to $1,600 per tooth. Bone grafting procedures can cost anywhere from CAD $300 to $1,600 per site, depending on the material used and the complexity of the treatment. Guided tissue regeneration (GTR) may cost between CAD $1,400 and $4,000 per site.

Keep in mind that dental insurance coverage varies, and it is essential to review your specific policy and consult with your insurance provider to determine the extent of your coverage for periodontal surgery.

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