Periodontal diseases are diseases that can be largely prevented and controlled. Treatment depends on ensuring good oral hygiene, correct and early diagnosis, and correct treatment approaches. Therefore, both the patient and the physician should actively participate in the treatment.
First Stage of Treatment
The most important stage in periodontal treatment is the elimination of infection and the patient learning to maintain oral health by applying cleanliness between gingiva and teeth effectively and regularly. In order to eliminate infection, the surface of the microbial dental plaque, the tooth stone and the root that causes the disease must be cleaned by the physician and the patient must be protected from this situation.This process is called “pretreatment”, it is an necessary stage in the treatment of all types of periodontal diseases and is performed in 3-4 sessions depending on the condition of the case. During pretreatment, removal of local factors that facilitate bacterial retention,such as replacement of bad, excessive fillings and filling of rotten teeth, the correction of dentures that are incompatible with the gingiva edge and whose shape is not correct, should be performed. Root canal treatments and untreatable tooth extraction should also be performed. In addition, medical consultations are also performed at this stage if there is a systemic disease. At this stage, planning for possible prosthetics is also necessary.
Second Stage of Treatment
Periodontist will recommend periodontal surgery procedures,if in the initial periodontal treatment phase has detected a completely incurable condition. Pocket depths remaining after initial periodontal treatment, gingival enlargement and recession, bone thinning and shape of bone thinning, the amount of gingiva affect the decision to be taken. All periodontal diseases and defects cannot be treated with the same surgical procedures. The factors that determine the choice of treatment are the characteristics of the patient and tissue and the course and prevalence of existing periodontal disease.
The main purpose of surgical periodontal treatment is, eliminating pocket depths, trying to make bone-gingiva and tooth relationship look like the original, thus creating an environment that the patient and the physician can easily clean. Therefore, it is also called “corrective treatment”.
Surgical Treatment Types
Operations are carried out under local anesthesia. Medical consultations and examinations are requested before the operation when necessary.
Gingivectomy
It is a procedure that concerns only the gingiva. The cutting and removal of a piece of gingiva,to eliminate the gingival pocket and gingival englargement. Thus, the progression of the disease stops, the patient has easy to clean and a more aesthetic gingiva.
Flap and Bone Surgery Process
It is a process that concerns both the gingiva and the supportive tissues and root surfaces underneath. It is applied in cases with bone thinning. With this technique, the gingiva are upraise appropriately and the underlying tissues are reached and treated. The main purpose of the process are complete cleaning of root surfaces and reducing pocket depth.
As mentioned before, it is important to eliminate these pockets as bacteria in deepening pockets will lead to more bone destruction and loss of teeth. After the operation, pocket depths are reduced or eliminated, making it possible to maintain periodontal health by making it easier for the patient to maintain home care and professional controls of the physician. The patient can protect his natural teeth and is also protected from general health problems caused by infection from pockets.
The underlying bone tissue is also treated during flap surgery. These procedures are called “Orthopedic Surgery”. After upraise the gingiva during the flap operation, dead soft tissues, root surfaces and also pockets inside the bone are cleaned. Thus, the current bone shape during the operation is evaluated.Then, resective techniques are used to correct the bone shape to resemble its original shape or bone repair is performed by regenerative methods and pockets are filled inside the bone to be brought to the original bone level is attempted. Natural or artificial bone meal in this technique various materials such as membranes and protein structure substances are used. In most cases, reconstructive and regenerative techniques are applied together. It is important to correct shape of the bone for a healthy relationship with the gingival tissue above it.
Mucogingival Surgery
They are processes that concern soft tissues in the mouth. It is applied when inadequate attached gingiva,gingival recession, high muscle connections. Thus,In this way, the environment in which the patient can provide oral care and adequate amount of gingiva to support the dentures is provided.It is aimed to eliminate aesthetic and sensitivity problems.
Third Stage of Treatment
According to the condition of the case, patients are taken in the control program at regularly in order to maintain periodontal health obtained after non-surgical and surgical treatments and to prevent the repetition of the disease.After a successful periodontal treatment, tissue destructions begin again in a short time in patients who are not taken control program and do not provide their own oral care, symptoms of the disease appear. (increased pocket depth, bone thinning and loss of tooth happens) The patient should be examined by periodontist with periods of 3-6 months, which vary according to the case.