There are typically four applications for periodontal plastic surgery:
- Clinical crown lengthening to expose more of the teeth for an attractive smile or access for restorations and improved retention of crowns .
- Root coverage procedures to protect the roots from erosion, decay, and sensitivity while providing an attractive, symmetric appearance.
- Establishment of a functional zone of attached, keratanized gingiva (gums) to prevent recession.
- Augmentation procedures to reestablish normal tissue contours for a more attactive and hygienic restorative result.
Periodontal plastic surgery can be performed in our office with local anesthesia and some form of sedation, if necessary.
What advances have increased the predictability of esthetic periodontal surgery?Improved root preparation techniques have greatly advanced grafting procedures. Enhanced magnification and illumination provide for superior visual acuity. Smaller instruments, needles, and sutures allow for precise surgical margins and minimal tissue trauma. The result of these advances has been shorter healing times, absence of scarring, and an esthetically pleasing blending of gingival contours and color.
Even levels of gingiva achieved by tissue recontouring.
The photographs above vividly illustrate the esthetic advances in periodontal plastic surgery. This patient had an existing connective tissue graft and temporary crowns. Notice the superior color and contours of the healed tissues after ginival recontouring and the permanent crowns in place.
Why are restorative dentists increasingly recommending periodontal plastic surgery for their patients?In recent years, the demand for cosmetic dentistry has steadily increased. This has been accompanied by higher patient expectations for an esthetically pleasing final result. Even the finest restorative treatment can be an esthetic dissapointment if the periodontal component is not factored into the total treatment plan.
With sophisticated surgical procedures I, as a periodontist, can provide an ideal gingival frame for restorative dentistry. General dentists, prosthodontists, and orthodontists are increasingly coordinating treatment with me to achieve the highest level of health, symmetry, and esthetics. Often a collaborative effort can be the difference that ensures success and patient satisfaction.
What is the appropriate treatment sequence for esthetic periodontal procedures?Preposthetic communication between the periodontist and the restorative dentist is necessary.
Periodontal procedures are usually completed prior to the initiation of restorative treatment. In some cases periodontal surgery is appropriate while the patient has provisional (temporary)restorations. Periodontal procedures should be completed before impressions are taken for the final restorations.
What is the expected longevity of esthetic periodontal surgery?The long-term stability of periodontal plastic surgery is excellent. As with other periodontal procedures, long-term success is greatly enhanced by regular professional supervision and supportive periodontal therapy, effective plaque control, and a stable, non-traumatic occlusion.