Indications and Contraindications for Periodontal Surgery
- Indications:
- Poor standard of plaque control
- Questionable long-term prognosis of patient dentition
- Pregnancy
- Smoking
- Severe cardiovascular disease
- Contraindications:
- Malignancy
- Bleeding disorders
- Uncontrolled diabetes
- Kidney disease
- Liver disease
Considerations for Periodontal Surgery
- Procedural selection:
- Relies on simplicity, predictability, and efficiency
- Mucogingival considerations:
- Should be taken into account
- Osseous topography and anatomic limitations:
- Should be considered
- Age and systemic factors:
- Should be evaluated
- Incisions:
- Clear, smooth, and well-defined incisions minimize healing time
Surgical Procedures in Periodontal Surgery
- Crown lengthening:
- Performed for aesthetic or functional reasons
- Contraindications:
- Untreated or unstable gum disease
- Gingival phenotype
- Considerations:
- Strategic value of the tooth
- Crown/root ratio
- Aesthetics may be affected, such as longer clinical crowns and loss of interdental papillae
- Post-op sensitivity and the need for long-term treatment should be discussed with the patient
Frenectomy in Periodontal Surgery
- Indications:
- Thick, prominent muscle attachments
- Close frenum attachment to the gum margin
- Common sites for frenectomy:
- Buccal regions of upper and lower incisors, upper canines, and premolars
- Procedure:
- Involves cutting the frenum attachment, administering local anesthesia, and suturing the wound
- Benefits:
- Improves gum contour
- Reduces plaque accumulation and inflammation
- Post-operative care:
- Rinsing with chlorhexidine mouthwash
General Information
- Periodontal surgery is a surgical intervention for various periodontal conditions.
- It is important to assess the indications and contraindications before proceeding with the surgery.
- Considerations such as procedural selection, mucogingival considerations, osseous topography, anatomic limitations, age, and systemic factors should be taken into account.
- Different surgical procedures, such as crown lengthening and frenectomy, are performed based on specific indications and considerations.
- Post-operative care and patient education are essential for successful outcomes.
Periodontal surgery is a form of dental surgery that prevents or corrects anatomical, traumatic, developmental, or plaque-induced defects in the bone, gingiva, or alveolar mucosa. The objectives of this surgery include accessibility of instruments to root surface, elimination of inflammation, creation of an oral environment for plaque control, periodontal diseases control, oral hygiene maintenance, maintain proper embrasure space, address gingiva-alveolar mucosa problems, and esthetic improvement. The surgical procedures include crown lengthening, frenectomy, and mucogingival flap surgery.
