Dr. Akram E. Rafla Dr. Akram E. Rafla

Gum Grafting (Gingivectomy, Osseous Surgery) – Worcester, MA

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About Gum Grafting

When recession of the gingiva occurs, the body loses a natural defense against both bacterial penetration and trauma. When gum recession is a problem, gum reconstruction using grafting techniques is an option.

When there is only a minor recession, some healthy gingiva often remains and protects the tooth, so that no treatment other than modifying home care practices is necessary. However, when recession reaches the mucosa, the first line of defense against bacterial penetration is lost.

In addition, gum recession often results in root sensitivity to hot and cold foods as well as an unsightly appearance of the gum and tooth. When significant, gum recession can predispose to worsening recession and expose the root surface, which is softer than enamel, leading to root caries and root gouging.

A gingival graft is designed to solve these problems. A thin piece of tissue is taken from the roof of the mouth or gently moved over from adjacent areas to provide a stable band of attached gingiva around the tooth. The gingival graft may be placed in such a way as to cover the exposed portion of the root.

The gingival graft procedure is highly predictable and results in a stable, healthy band of attached tissue around the tooth.

Gingivectomy

The gum tissue can be very thick and large covering the tooth surface making the teeth look short. the can happen because of medications, bone that extends too close to the surface of the teeth, or inflammation due to gum disease.

A gingivectomy is a periodontal procedure that eliminates excess gum tissue. The term "gingivectomy" is derived from Latin:

  • "gingiva" means gum tissue,
  • "-ectomy" means to remove.

The following are some reasons a gingivectomy might be needed:

Cosmetics: To make the teeth look normal in size when the gum is covering too much of it, making the teeth look longer and more proportional.

Functional/Esthetics: To remove excess gum tissue (gingival overgrowth) that has formed as a result of certain drugs such as anti-seizure and organ-transplant medications, and certain high blood pressure medications.

Bone and gum health around the teeth: To shrink deep gum pockets. This procedure might require some bone work as well.

 

Procedure Technique

We first will anesthetize the area(s) to be treated. The excess of gum tissue is removed either with a scalpel blade and sometimes some rotary instruments or a laser. In most cases no sutures (stitches) are required. The surgical sites will be sore for 24-48 hours, and medication will be provided to alleviate any discomfort experienced. A week follow-up appointment is usually needed to ensure proper healing.

Osseous Surgery

Osseous surgery, sometimes referred to as pocket reduction surgery or gingivectomy, refers to a number of different surgeries aimed at gaining access to the tooth roots to remove tartar and disease-causing bacteria.

Goals of Ossoeus Surgery

Osseous surgery is used to reshape deformities and remove pockets in the alveolar bone surrounding the teeth. It is a common necessity in effective treatment of more advanced periodontal diseases. The ultimate goal of osseous surgery is to reduce or eliminate the periodontal pockets that cause periodontal disease. Despite the word “surgery” the procedure is reported to feel more like a thorough cleaning. The specific goals of surgery include:

  • Reducing Bacterial Spread:
    Bacteria from the mouth can spread throughout the body and cause other life-threatening conditions such as heart disease and respiratory disease. Removing deep tartar and thereby bacteria can help reduce the risk of bacteria spreading.
  • Preventing Bone Loss:
    The immune system’s inflammatory response prompted by periodontal bacteria can lead to bone loss in the jaw region, and cause teeth to fall out. Osseous surgery seeks to stop periodontal disease before it progresses to this level.
  • Enhancing the Smile:
    Mouths plagued with periodontal disease are often unsightly. Brown gums, rotting teeth, and ridge indentations can leave a person feeling depressed and too self-conscious to smile. Fortunately, osseous surgery can help reduce bacteria and disease and thereby restore your mouth to its former radiance, while restoring confidence at the same time.
  • Facilitating Home Care:
    As the gum pocket deepens, it can become nearly impossible to brush and floss adequately. Osseous surgery reduces pocket size, making it easier to brush and floss, and thereby prevent further periodontal disease.

Osseous Procedure Technique

A local anesthetic will be used to numb the area prior to surgery. First, Dr. Rafla will cut around each tooth of the affected area to release the gum tissue from the bone. This allows access to the bone and roots of the teeth. After the roots have been thoroughly cleaned through scaling, a drill and hand tools will be used to reshape the bone around the teeth. Bone is removed in some areas to restore the normal rise and fall of the bone but at a lower level. Bone grafting may also be necessary to fill in large defects.

Next, the gums will be placed back over the remaining bone and suture them in place. The site will also be covered with a bandage (periodontal pack) or dressing. Pain medicine and mouth rinses containing chlorhexidine the following the surgery.

Do not be alarmed if bleeding and swelling occur after the surgery. This can be controlled easily by placing an ice pack on the outside of the affected area. In cases where the bleeding and swelling is in excess, it is advised that you call to notify our office. Several follow up visits may be necessary and you must fulfill a meticulous maintenance program especially during the initial phases of healing to avoid post-operative infection.

*Individual results are not guaranteed and may vary from person to person. Images may contain models.