Flap surgery is indicated in Advanced Periodontitis. Here an incision is made over gum contour and access to the root surface is gained by flap elevation. The infected tissue is removed by scaling and curettage. Later the root surface is smoothened to avoid future bacterial invasion and gum is sutured back. In this process, if any bony defects are evident, bone grafts are indicated. Flap surgery can be done either by conventional surgical methods or by using lasers.
In this revolutionalised era of technology, with advent of lasers in dentistry the surgical procedures have become more easier and convenient. Unlike conventional methods where an incision is made with asurgical knife, laser uses a ray of amplified light to make an incision and destroy the periodontal pathogens.
Simple brushing & flossing of teeth & using mouth rinse would be sufficient to maintain gums in healthy state.The bacteria in the plaque get killed by these procedures & therefore we can protect gums from gum diseases.
The sticky adhesive plaque which develops on the teeth surfaces if not cleaned properly through regular methods like brushing & flossing, plaque develops into tartar which in turns provides rough surface for accumulation of plaque. If this process of plaque & tartar(calculus)accumulation continues to grow on the tooth surface, slowly the bacteria in the plaque infects the gum tissue that surrounds the tooth resulting in inflammation of gums giving it red, swollen appearance. The gums even become tender & bleed even on brushing. This condition of gums is referred to as “Gingivitis”. At this stage of Gingitivitis, if the teeth are cleaned by a dental professional the condition of gums can be reversed.
If the plaque & tartar (calculus) is not removed at this stage, bacteria in the plaque /tartar (calculus) invades the periodontal tissues of teeth i.e. supporting soft tissue fibres around the teeth resulting in formation of pocket around the teeth, which further attracts bacteria to infect. Here we can notice pus in between tooth which we can appreciate on pressuring gums. Moreover red, swollen, bleeding gums accompany this situation. These conditions together referred to as Periondontitis. In this stage of Periodontitis, Periodontal therapy performed by dentist along with patient personal hygiene could help to sort out this problem of periodontitis.
At the stage of periodontitis even if patient neglects to get the treatment done for gums, the bacteria in the plaque & calculus (tartar)infects the underlying bone along with periodontal tissues resulting in loosening of teeth. This condition where bacteria infect bone & periodontal tissues is referred to as “Advanced Periodontitis”. In this stage patient will experience difficulty in biting & chewing food even. The appropriate treatment for this condition includes some surgical correction of periodontal tissue, with periodic dental cleaning & patient personal hygiene. Over this the dentist would to suggest removal of loosened teeth evaluating the bone support present around that particular tooth & also advises the prosthetic replacement methods to replace that tooth.