Flap Surgery. FSurgery might be necessary if inflammation and deep pockets remain following treatment
with deep cleaning and medications. A dentist or periodontist may perform flap surgery to remove tartar deposits
in deep pockets or to reduce the periodontal pocket and make it easier for the patient, dentist, and hygienist
to keep the area clean. This common surgery involves lifting back the gums and removing the tartar. The gums are
then sutured back in place so that the tissue fits snugly around the tooth again. After surgery the gums will heal
and fit more tightly around the tooth. This sometimes results in the teeth appearing longer.
Bone and Tissue Grafts. In addition to flap surgery,your periodontist or dentist may suggest
procedures to help regenerate any bone or gum tissue lost to periodontitis. Bone grafting, in which natural or
synthetic bone is placed in the area of bone loss, can help promote bone growth. A technique that can be used with
bone grafting is called guided tissue regeneration. In this procedure, a small piece of mesh-like material is inserted
between the bone and gum tissue. This keeps the gum tissue from growing into the area where the bone should be,
allowing the bone and connective tissue to regrow. Growth factors – proteins that can help your body naturally
regrow bone – may also be used. In cases where gum tissue has been lost, your dentist or periodontist may suggest
a soft tissue graft, in which synthetic material or tissue taken from another area of your mouth is used to cover
exposed tooth roots.
Since each case is different, it is not possible to predict with certainty which grafts will be successful
over the long-term. Treatment results depend on many things, including how far the disease has progressed, how
well the patient keeps up with oral care at home, and certain risk factors, such as smoking, which may lower the
chances of success. Ask your periodontist what the level of success might be in your particular case.