Cosmetic Periodental Treatment

Gingivoplasty and Gingivectomy

is a type of gum surgery used to reshape healthy gum tissue around teeth. It often is done simply to make gums look better. The gum may have an unusual shape or may not be formed normally. The causes can include a person's genes, disease or trauma. Gingivoplasty reshapes the gums to make them look more natural. It often is done alone, but can be done during or after a gingivectomy. Gingivoplasty also can be done along with a gum graft. This type of surgery adds tissue to the gum line.

Procedure

Gingivoplasties usually are done with scalpels. They also can be done with electrosurgery or laser units. The periodontist might use special tools that were designed for gingivectomies. They have angled blades to help them get around teeth.

Before either procedure, you will receive a local anesthetic shot to numb your gums. The length of time depends on how much tissue is being removed. Gingivoplasties typically are done in a couple of minutes. 

Follow Up

After either procedure, a periodontal dressing will be placed on your gums to protect the wound for a week to 10 days. A periodontal dressing is soft and has the texture of modeling clay. During this time, you will need to follow a somewhat soft diet and avoid spicy and crunchy foods. Your dentist might give you prescriptions for pain medicine and an antiseptic mouthwash.

It is very important to keep your mouth clean during the healing period. You should not brush your teeth in the surgical area while the periodontal dressing is in place. You will be able to brush and floss the rest of your mouth normally. When the pack comes off, you can brush and floss normally, but ently. The healing tissues may bleed when you floss or brush right after the dressing is removed. Your gums will begin to look normal in three to four weeks. It can take two to three months for the tissue to heal completely.

Risks

There are no major risks to either procedure. Infection and prolonged bleeding may occur. However, this is unusual. The affected area might ooze blood for the first 24 to 48 hours. After that, it should not bleed much, if at all. 


Crown Lengthening

is done when a tooth needs to be fixed. Sometimes, not enough of the tooth sticks out above the gum to support a filling or crown.

This can happen when a tooth breaks off at the gum line. It also can happen when a crown or filling falls out of a tooth and there is decay underneath. To place a filling or crown, your dentist needs to expose more of the tooth. This is done by removing some gum tissue or bone. Some people have a lot of gum tissue around their upper teeth. Dentists call this "gummy smile." This also can be treated with crown lengthening.

Crown lengthening to enhance the success of a dental restoration

Before

After

 

Esthetic Crown lengthening

Before

After

 


Procedure

Crown lengthening is done using local anesthesia. How long it takes will depend on the number of teeth that need treatment. Even if only one tooth is involved, crown lengthening typically includes neighboring teeth, too. That allows the tissues to be reshaped gradually. If both bone and soft tissue are removed, the procedure will take longer than if only soft tissue is removed.

The periodontist will make cuts that will pull the gums away from the teeth. This will expose the roots of the teeth and the surrounding bone. In some cases, simply removing a little gum tissue will expose enough tooth for your dentist to place a crown or filling. However, in most cases, the periodontist will need to remove some bone from around the roots of the teeth. Once the periodontist has exposed enough tooth, the surgical area will be washed with sterile salt water and the gums will be stitched together. Some dentists put a bandage over the stitches.

If you have temporary crowns on any of the involved teeth, the crowns may be removed before the procedure begins. The periodontist will put them back afterward.

You will be given prescriptions for a pain reliever and a mouth rinse. Your dentist will ask you to follow a somewhat soft diet. You can brush the teeth near the stitches, but avoid the gums. Remove food particles with a toothpick or a water irrigator.

After the tooth is completely numbed the periodontist will make an incision.

The gums are gently lifted to expose the alveolar bone crest.

The bone and gum tissue is then reshaped.

 

The depth is just enough to expose more of tooth length to create secure anchor for a crown.

Couple of stitches are placed to speed healing

After a few weeks of healing, a crown is placed to cover and protect the damaged tooth.

* Crown lengthening is a predictable and effective way to save the tooth that might otherwise, we lost.


Follow Up

For the first two days, use ice on your face. This will reduce swelling.
You will go back to the periodontist in 7 to 10 days to have the stitches taken out. You will go back again 4 to 6 weeks later for a follow-up visit.
Your gums should heal for about three months before the tooth is prepared for the final crown. Gums can shrink as they heal. If you don't wait long enough, the edges of the crown could show. Your regular dentist will put in the crown or filling.

Risks

The area may bleed for some time after the procedure. In addition, an infection may develop after the surgery. These complications may occur after any type of surgery.
Some people find that after the surgery, their teeth are sensitive to hot and cold. This is because the roots of the teeth are now exposed. The sensitivity goes away with time, or when a crown is put on the tooth.
Because of the tissue and bone removal, the affected tooth may look longer than the teeth next to it.
Removing bone from around a tooth can make it feel looser. If that tooth is ever lost, it could be more difficult to put in a dental implant to replace it. The periodontist will talk about these possibilities with you.

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