Periodontal Surgical Procedures & Anesthesia
Periodontal Surgery
The main cause of periodontal disease is bacterial plaque. If not removed thoroughly, plaque-induced toxins destroy the supportive structures around your teeth. Access to hidden areas (pockets) beneath the gum line where bacteria grow allows for the thorough removal of the bacteriaand resealing of the gum attachment.
Gingivectomy/Gingivoplasty
These procedures reduce and reshape, respectively, excess gum tissue. Gum overgrowth can be caused by certain oral medications, orthodontic therapy, mouth breathing, or bacterial plaque. Gingivectomies/Gingivoplasties are often performed to improve appearance and facilitate better hygiene.
Guided Bone Regeneration / Bone Grafting
I can predictably achieve re-growth of jawbone lost due to atrophy or periodontal disease. New advances on gene biology have allowed us to combine patients' blood-derived proteins, called bone growth factors, with a bone graft and stimulate superior bone formation.
The oldest technique used in regeneration surgery calls for placing various materials in the bone defect, to stimulate the patient's bone to re-grow. Bone grafting has been used for over 75 years, but today's materials are much superior in stimulating new bone to form. The implanted material is resorbed by the body, and after 6-12 months has completely disappeared, replaced by new bone. Various materials are available, with the selection made on a case by case basis.
Functional Crown lengthening
Tooth decay, trauma, and tooth eruption abnormalities can destroy the tooth structure above and below the gum line. Crown lengthening surgery involves the removal of gum or bone to create adequate tooth structure so that your dentist can construct a healthy dental restoration.
If the dentist is unable to reach decay that is deep under the gum, the tooth will be lost. As a rule, simply trimming back the gum is not sufficient, as the underlying bone would be exposed. Rather, the periodontist must reflect a flap, trim back the bone to allow for access to the decay, and then suture the gum back at the lower level. Sufficient bone must be removed to allow room below the decay for the gum to reattach to the tooth.
Decay far under gum.
Flap reflected to access decay.
Bone trimmed for access to decay and to allow room for gum to reattach.
Gum replaced with decay visible for dentist to restore with filling or crown.
Most crown lengthening procedures are very straightforward, and there is little or no post-operative discomfort. Sutures and dressing are removed after about 2 weeks, and in many cases a 5-minute "touch-up" surgery is done after 4-6 weeks to establish ideal tissue form. This secondary procedure requires no sutures or dressing, and has no post-operative discomfort.
If a crown is to be placed in a cosmetic area, the restorative dentist should wait 8 weeks following crown lengthening before taking final impressions. This ensures that the gum, which shrinks slightly as it re-attaches to the tooth during healing, is in its final position. If the margin of the crown is placed at the gum level before final healing, and additional shrinkage occurs, the results may be unsightly. A temporary crown can be placed two weeks after surgery if the patient desires to cover the exposed root during this healing period.
Patient Comfort Options
Your well being is extremely important to me, and I will do everything I can to provide for a comfortable experience.
Local Anesthetic
Many procedures are performed with local anesthesia. Special medications are applied topically to numb the area prior to receiving the anesthetic.
Intravenous Sedation
Dr. Mecall is fully qualified and licensed by the state of Nevada to deliver intravenous sedation for your comfort.
Conscious sedation, which includes a twilight sleep, allows you to breathe on your own and comply with the doctor's instructions, while feeling completely relaxed. You will remember very little of the procedure once the sedation has lifted. Special monitoring equipment is used to enhance patient safety and comfort during all sedation procedures. The American Heart Association certifies Dr. Mecall in Basic and Advanced Cardiac Life Support.
Because your family dentist plays a crucial role in preventing and minimizing periodontal disease, I strongly urge you to continue to visit him or her regularly.