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Gingival Flap

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One of the most common dental problems is development of plaque that turns into calculus when teeth are not brushed properly. Only a professional can help clean this hard calculus and get rid of it for good. However, if this corrective step is not taken, it can continue to spread and leads to gingivitis. The gums become red, swollen and bleeds easily. Daily brushing and flossing can help reverse the condition along with a professional clean up by a dentist. However, when this corrective measure is skipped, the infection continues to spread causing periodontitis.

This means the inflammation spreads around the tooth as well as causes jaw bone loss. The gums begin to pull away from the teeth, causing spaces called as pockets. These pockets become infected and bacteria begin to thrive in them. They produce bacterial toxins that starts breaking down the bone and connective tissue that holds the teeth in place. Treatment at this stage is absolutely necessary as it can lead to the destruction of the gums, tissue and jaw bones due to infection. Thus, the teeth eventually lose their hold and fall down or need to be removed with professional help.

There are different surgical treatments for periodontal disease. One such treatment is called as gingival flap surgery. Let us learn more about gingival flap surgery in the following paragraphs.

What is Gingival Flap Surgery?   

Gingival flap surgery is a procedure wherein the gumsseparate from the teeth and folded back for some time to allow the dentist to more visibility and access to the bone and root surface.

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Why is Gingival Flap Surgery Required?

The surgery helps in treatment of advanced or moderate periodontitis, especially when scaling and root planning are not helpful in elimination of gum infection. In some cases, gingival flap surgery is planned along with another procedure called as osseous (bone) surgery. It also helps in the maintenance of the attached tissue as well as elimination of pockets.

What are the Specific Procedures Related to the Surgery?

There are different types of procedures related to gingival flap surgery. These include:

  • Coronally and apically positioned flaps where the gingival tissue is freed and moved coronally or apically
  • Free gingival graft where a small layer of tissue is removed from the palate and sutured on a site of gum recession. It is done to help protect the exposed root as living tissue.
  • Subepithelial connective tissue graft where healthy gum tissue from the palate is taken and placed on area of gum recession. This procedure is less painful than free gingival graft.
  • Lateral pedicle graft where tissue is taken from the immediate adjacent area of the damaged gingiva. However, this option is not always preferred as it increases the risk of recession at the donor site as well.
  • Acellular dermal matrix is the use of graft from medically processed human skin tissue that is donated.

How is One Prepared for the Surgery?

The dentist will remove all the plaque and tartar from around the teeth. The oral hygiene has to be good before the surgery takes place. The doctor will also take into consideration the overall health, current medications the patient is on and then consider the surgery.

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How Is It Carried Out?

Local anesthesia will be given the site of surgery. The periodontist will check if the area is numb and then use a scalpel to separate  gums from the teeth. Then, he/she will lift up the gum and fold them back to form a flap. This will provide direct vision and access to the roots and bone of the teeth. The inflamed tissue will be removed and any pockets from the bone eliminated.

The dentist will then carry out scaling and root planning to clean the plaque and tartar on the teeth. Any bone defects will be removed with the help of osseous recontouring. This helps smoothen out the edges of the bone with the help of files or rotating burs.

Once the procedure is complete, the gums will be placed back on the teeth and sutured in place. Most of the time, the sutures used, dissolve on their own. In some cases, you will have to go back to the dentist to get them removed. The surgical site may be covered with the help of intraoral bandage called as a periodontal pack or dressing.

What Happens After the Procedure?

You may develop mild or moderate pain or discomfort after the procedure. However, you will be prescribed with pain medications to counter the discomfort. Make sure the site of surgery is as clean as possible. Brush and floss your mouth normally. In case a periodontal pack is not used, you can brush gently to remove plaque from the teeth. Use antimicrobial mouth rinses to get rid of bacteria in the mouth.

Use an ice pack on the outside of the face, in case of any swelling. Any bleeding that does not stop, should be reported immediately to the dentist.

After a gingival flap surgery, the gums may continue to recede after healing. The teeth may also get more sensitive to cold and hot temperature. The risk of cavities may also increase after surgery. Speak to your dentist in detail regarding the gingival flap surgery and clear any doubts before undergoing the procedure.

Written by: healthplus24.com team

Date last updated: Jnuary 22, 2015