Only in cases of advanced periodontitis and only after the initial non-surgical phase the surgical treatment of periodontitis is indicated.
In advanced periodontitis, the bone and gingival tissue that supports the dental elements is destroyed and the periodontal pockets are deepened creating a wider space where bacteria can proliferate.

Although the patient has excellent oral hygiene, surgical therapy is indicated because home hygiene maneuvers do not allow to place the bristles of the toothbrush below the gum for more than 0.8mm.

If surgery is not performed, the pockets would tend to deepen, the alveolar bone to resorb and if this loss is advanced, extraction could be the only therapy possible.

The surgical approach consists of removing the diseased tissue (the pocket) and reconstructing soft (gingiva) and hard (alveolar bone) tissues in order to obtain an anatomy that allows permanent elimination of pockets, bone defects (craters), and to promote home hygiene maneuvers. The surgery technique, known as "resective bone surgery", has undergone considerable changes in recent years in order to eliminate periodontal pathology while retaining a gingival appearance that is as aesthetic and atraumatic as possible.

What are the benefits of "Resective bone surgery"?
The main advantage of resective bone surgery is the reduction of periodontal pockets, peri-dental bone defects, bacteria responsible for periodontitis and its progression, and the maintenance of dental elements and a healthy smile. The only elimination of bacteria, as in non-surgical therapy, is not sufficient to prevent recurrences. Deep pockets are impossible to clean for the patient, so it is important to reduce them so that the patient can maintain healthy gums and teeth with home care and professional maintenance. A healthy periodontium allows teeth to be maintained over time and to prevent any systemic diseases (for example cardiovascular diseases, diabetes, etc.).

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