Periodontal Flap Surgery

Online Dental Education Library

Our team of dental specialists and staff strive to improve the overall health of our patients by focusing on preventing, diagnosing and treating conditions associated with your teeth and gums. Please use our dental library to learn more about dental problems and treatments available. If you have questions or need to schedule an appointment, contact us.

 


A

Air abrasion - is a drill-less technique that is being used by some dentists to remove tooth decay and for other applications
Amalgam - Material made from mercury and other alloy mixtures used to restore a drilled portion of a tooth. 
Anesthesia - Medications used to relieve pain.
Anterior teeth - Front teeth. Also called incisors and cuspids.
Arch - The upper or lower jaw.

B
Baby bottle tooth decay - Caused by sugary substances in breast milk and some juices, which combine with saliva to form pools inside the baby's mouth.
Bicuspids -Back teeth used for chewing.
Bitewings - X-rays that help a dentist diagnose cavities.
Bonding - Application of tooth-colored resin materials to the surface of the teeth.
Bridge - A fixed or removable appliance that replaces lost teeth.
Bruxism - Teeth grinding.

C
CAD/CAM dentistry, (Computer-Aided Design and Computer-Aided Manufacturing in dentistry), is an area of dentistry utilizing CAD/CAM technologies to produce different types of dental restorations, including crowns, crownlays, veneers,  inlays and onlays, fixed bridges, dental implant restorations and orthodontic appliances.
Calculus (tartar)-  Calculus is hardened plaque (a sticky substance) that has been left on the tooth for some time and is now firmly attached to the tooth surface. Calculus forms above and below the gum line and can only be removed with special dental instruments.
Canal - The narrow chamber inside the tooth's root.
Canines - Also called cuspids.
Canker sore - One that occurs on the delicate tissues inside your mouth. A canker sore is usually light-colored at its base and can have a red exterior border. 
Caries - Another term for decay, which causes cavities.
Cold sore - Usually occurs on the outside of the mouth, usually on or near the nose or lips. A cold sore is contagious because it is caused by the herpes simplex virus, and it is usually painful and filled with fluid. 
Composite filling - Tooth colored restorations, also known as resin fillings. 
Composite resin - A tooth colored resin combined with silica or porcelain and used as a restoration material.
Contouring - The process of reshaping teeth.
Crown - An artificial cover that is placed on the top of a tooth following restoration.
Cusps - The pointed parts on top of the back teeth's chewing surface.
Cuspids - Front teeth that typically have a protruding edge.

D
Dentin - The tooth layer underneath the enamel.
Denture - A removable set of teeth.

E
Endodontics - A form of dentistry that addresses problems affecting the tooth's root or nerve.

F
Fluoride - A naturally occurring substance added to water, toothpastes and some rinses and used for strengthening the tooth's enamel.
Fluorosis - A harmless over-exposure to fluoride and resulting sometimes in tooth discoloration.

G
Gingiva - Another word for gum tissue.
Gingivitis - A minor disease of the gums caused by plaque.
Gum disease - An infection of the gum tissues. Also called periodontal disease.

I
Impacted teeth - A condition in which a tooth fails to erupt or only partially erupts.
Implant - A permanent appliance used to replace a missing tooth.
Incisor - Front teeth with cutting edges; located in the center or on the sides near the front.
Inlay - An indirect artificial filling made of various materials, including porcelain, resin, or gold.  fitted to a cavity in a tooth and cemented into place.
Intracoronal - situated or made within the crown of a tooth

L
Laminate veneer - A shell that is bonded to the enamel of a front tooth. The shell is usually thin and made from porcelain resin.

M
Malocclusion - Bad bite relationship
Mandible - The lower jaw
Maxilla - The upper jaw
Molar - Usually the largest teeth, near the rear of the mouth. Molars have large chewing surfaces

N
Nightguard - Night mouth guards are bite pads that are worn at night as you sleep. There are also used as mouth guards for day use. These guards are made of high-grade plastic and are custom fit to the mouth. This device keeps the upper teeth from grinding with the lower teeth, offering an instant solution to teeth clenching problems.
Neuromuscular Dentistry - Are more than the aches and pains felt in and around the neck and head that are associated with your teeth and jaw.

O
Onlay - An indirect artificial filling made of various materials, including porcelain, resin, or gold;  fitted to a cavity in a tooth and cemented into place. It is designed to protect the chewing surface of a tooth by extending to replace a cusp.
Orthodontics - A field of dentistry that deals with tooth and jaw alignment.
Overdenture - A non-fixed dental appliance applied to a small number of natural teeth or implants.

P
Palate - Roof of the mouth.
Partial denture - A removable appliance that replaces teeth. Also called a bridge. 
Pedodontics - A field of dentistry that deals with children's teeth.
Perio pocket - An opening formed by receding gums.
Periodontal disease - Infection of the gum tissues. Also called gum disease.
Periodontist - A dentist who treats diseases of the gums.
Permanent teeth - The teeth that erupt after primary teeth. Also called adult teeth.
Plaque -Plaque is a sticky, colorless, almost invisible film or substance that forms on the teeth after sleep or periods between brushing. It is a growing colony of living bacteria, food debris, and saliva. 
Posterior teeth - The bicuspids and molars. Also called the back teeth.
Primary teeth - A person's first set of teeth. Also called baby teeth or temporary teeth.
Prophylaxis - The act of cleaning the teeth.
Prosthodontics - The field of dentistry that deals with artificial dental appliances.
Pulp - The inner tissues of the tooth containing blood, nerves and connective tissue.

R
Radiographs - Diagnostic X-rays essential for detection of decay, tumors, cysts, and bone loss.  X-rays also help determine tooth and root positions.
Receding gum - A condition in which the gums separate from the tooth, allowing bacteria and other substances to attack the tooth's enamel and surrounding bone.
Resin filling - An artificial filling used to restore teeth. Also called a composite filling.
Root canal - A procedure in which a tooth's nerve is removed and an inner canal cleansed and later filled.
Root planing - Scraping or cleansing of teeth to remove heavy buildup of tartar below the gum line.

S
Sealant - A synthetic material placed on the tooth's surface that protects the enamel and chewing surfaces.

T
Tartar - A hardened substance (also called calculus) that sticks to the tooth's surface.
Tooth decay –   Tooth decay occurs when the acids found in plaque erode the natural enamel found on the teeth.  This phenomenon can easily be prevented by using proper home hygiene methods. Tooth decay is one of the leading causes of tooth loss, and its treatment often requires complex dental procedures.Teeth polishing: Removal of  stain and plaque that is not otherwise removed during tooth brushing and scaling.
TMD - Temporomandibular joint disorder. Health problems related to the jaw joint just in front of the ear.

V
Veneer - A laminate applied or bonded to the tooth.

W
Whitening - A process that employs special bleaching agents for restoring the color of teeth.
Wisdom tooth - Third set of molars that erupt last in adolescence.
 

Tooth Wear.When advanced gum disease (periodontitis) develops, your teeth are in danger: At this stage, the ligaments and bone tissue that surround them are being destroyed, and you could even begin losing teeth! If the disease can't be controlled by non-surgical treatments like cleaning and scaling, then periodontal flap surgery may be your best treatment option.

Flap surgery is today's leading method for treating and repairing periodontal pockets. What are these “pockets?” They are areas below the gum line where gum tissue has detached from the teeth, resulting in an uncleansable space where harmful bacteria can proliferate. These bacteria cause inflammation of the tissues, resulting in sensitivity, bleeding, and pain. Left untreated, they can cause a host of problems including gum disease, loss of the tooth-supporting bone structure, and possibly even systemic (whole-body) problems.

When periodontal pockets develop, the first step in treating them is usually via cleaning and scaling (also referred to as root debridement) with a manual or ultrasonic instrument. If this isn't effective, then periodontal surgery is considered. Flap surgery isn't a cure for periodontal disease — but it helps create an environment that makes it easier to maintain your periodontal health. And even if you're prone to gum disease, proper professional treatment and regular care at home can help keep your teeth healthy for as long as possible.

The Goals of Flap Surgery

One major objective of flap surgery is to eliminate or reduce the pocket itself. To access it, a flap-like incision is made in the gum tissue. This allows diseased tissue to be removed from inside the pocket, and provides access to the teeth's root surfaces for a thorough cleaning, which helps to eliminate harmful plaque and calculus (tartar). Afterward, the “flap” is closed, sealing the area. This begins the healing process, which takes place rapidly.

Another goal is the regeneration of periodontal ligament and bone tissue which may have been lost to the disease. A variety of techniques may be used to accomplish this, including high-tech methods of bone grafting and chemicals referred to as growth factors. These approaches help restore the gums to their normal form and function, and promote the healthy and secure anchoring of teeth.

The Flap Surgery Procedure

Periodontal flap surgery.

Flap surgery is typically done under local anesthesia, sometimes accompanied by oral anti-anxiety medications; alternatively, it may be performed under intravenous conscious sedation. After anesthesia has taken effect, a small incision is made to separate the gums from the teeth. The outer gum tissue is gently folded back to give access to the roots and the supporting ligament and bone tissue.

Next, the inflamed gum tissue can be removed, and the tooth roots can be cleaned; if needed, the area may also be treated with antibiotics or other medications. Bone defects can be repaired with grafting material, and proper regeneration of the periodontal ligament can be encouraged by physical (barrier membranes) and chemical (growth factors) methods. Finally, the incision is closed and the procedure is completed.

Performed by an experienced hand, state-of-the-art flap surgery has an excellent track record and offers well-established benefits. It's often the treatment of choice for relieving periodontal disease and helping to maintain your oral health — and preserve your teeth.

Related Articles

Periodontal Flap Surgery - Dear Doctor Magazine

Periodontal Flap Surgery Most surgical patients are surprised by how comfortable the experience of flap surgery is and how painless it is afterward. Today's highly sophisticated and meticulous techniques allow the periodontal surgeon to reconstitute, regenerate, and reconstruct lost and destroyed tissues. Find out how periodontal surgery can prolong the life of your teeth... Read Article

Periodontal (Gum) Disease - Dear Doctor Magazine

Understanding Gum (Periodontal) Disease Have your gums ever bled when you brushed or flossed? This most commonly overlooked simple sign may be the start of a silent progressive disease leading to tooth loss. Learn what you can do to prevent this problem and keep your teeth for life... Read Article