Ideally when a crown is placed on a tooth it will stay at or above the gumline. However, it is often the case that decay extends beyond the gumline and the shape of the crown must match the pattern of decay on a tooth. When the crown extends below the gums this most frequently causes inflamed gum tissues which creates future problems in the tooth such as recession and pocketing. To prevent this from happening the gum tissue can be recontoured to promote a favourable environment for accepting a crown.
Basically speaking, we access the area of concern by making a small incision in the gums to access the underlying structures that support the teeth. Sometimes this is all that is needed if the only cause of inflammation is excessive gingival tissue. If the cause of inflammation is of boney origin then we must also recontour the underlying boney architecture to create a more favourable environment for the tooth. This is accomplished using hand instruments as well as drills. When the procedure is complete the gingival tissues are sutured into an appropriate position and a packing is placed over the site to increase post-operative patient comfort and minimize trauma to the area.
All patients are thoroughly anaesthetized during all procedures and discomfort is essentially non-existant. Post-operatively patients can expect minor discomfort, comparable to a bruise easily managed with anti-inflammatories
Gum grafts are done when a patient is experiencing recession in the gumline (getting “long in the tooth”). This recession can be a result of excessive brushing forces, gum disease, orthodontics, or simply genetics. To prevent further recession, and in some cases regain some of the loss that has occurred, we can replant tissue onto the site of interest thus increasing the amount of healthy tissue in the area.
During all grafting procedures the patient is well anaesthetized and experiences no discomfort. The original site of recession (recipient site) is prepared to receive extra tissue by making a small incision in the gingiva. The tissue to be replanted most frequently comes from the palate (donor site) where the gingival tissue is keratinized making it more durable. A small piece of tissue is removed from the palate, shaped and then placed into the recipient site. The tissue is sutured into place and a packing material is placed over both the donor and recipient sites to minimize post-operative irritation for the patient.
Pocket Reduction Surgery
When the gums are inflamed 2 things happen: the tissue becomes boggy and swollen and the underlying bone slowly erodes as the body tries to fight off the infection. As this process progresses we eventually end up with a large “pocket” between the gum tissue and the tooth where bacteria accumulate, which of course worsens the overall effect. In these cases it is sometimes necessary to recountour the shape of the gums to eliminate this pocket of bacteria.
Contact New Westminster dentists Dr. Doug Lovely & Associates today for more information on periodontal gum surgery or to book an appointment.