Periodontology is a branch of dentistry concerned on gingival illnesses and treatments which surround teeth and roots. Periodontology contains early period treatments such as tartar cleaning; surgical operations such as gingival operations, flap operations, papillae operation, deep curettage, implantology; and laser applications.
Even few minutes after we brush our teeth, a thin and opaque layer takes form on teeth and it is called biofilm. This layer leads to the actual detrimental structure called bacterial plaques (microbial dental plaque) which is formed consequent to bacterial invasion. Bacterial plaque should be removed from mouth; otherwise, it leads to “Gingivitis”.
The syndromes are erythema, swelling and bleeding gingivas. Generally pain and tingling are not seen during this phase. No loss of tissue is observed in adjacent tissues of tooth. If bacterial plaque remains within mouth for a long time, it can turn into tartar consequent to contamination of various minerals. What should be done in this stage is to consult with a dentist, to apply tartar cleaning process which is also called as “Preperiodontal Treatment” and remove bacterial plaque from mouth. After the process, oral care should be taken care of and regular controls should be followed.
If not treated, gingivitis leads to Periodontitis.
Dissimilar to gingivitis, losses of periodontal tissues and bone are seen in periodontitis and it means an irrecoverable stage. Periodontitis has various types. Genetic inheritance, badly maintained oral hygiene, particular systemic diseases can trigger formation and development of periodontitis. Gingival erythema and bleeding are clearly seen in periodontitis. Gingival recessions and gingival swellings are seen in places. In advanced cases, dangling teeth and even bone-loss related teeth losses can be seen.
Illness can quickly progress and can cause teeth losses. Pharmacotherapy can be required in addition to gingival treatment.
It is an illness which is seen in adults over 35 and which shows itself with deep pockets and gingival recessions. It progresses slowly; however, there can be cases with rapid progress.
The treatment of periodontitis should be done by a Periodontist, if possible. In addition to “Preperiodontal Treatment” applied in gingivitis, curettage and surgical operations might be needed.
In addition to “Preperiodontal Treatment”, deep curettage is applied according to severity of illness through scraping and cleaning including the parts under gingiva and through smoothing in order to prevent bacterial plaques from adhering to root surfaces.
In case curettage area is so deep and wide, Flap Operation is applied which is conducted through opening small cuts on gingiva, placing bone grafts on required places after curettage and finally suturing gingiva.
In cases of crowded teeth or jaw stenosis, in order to eliminate the need for future orthodontic treatment or at least to decrease the severity of required orthodontic treatment, dentition of following permanent teeth can planned, their timing can be adjusted and extraction of deciduous teeth can be conducted in a particular order and arrangement. This process is called dentition guidance.
There can be gaps between teeth and gingival problems in case Frenulums which connect lips with gingiva are longer and stronger than usual. Frenulums are shortened surgically, which is also called as Frenectomy as a process, in order to prevent these conditions.
Gingiva is shortened vertically with surgical operations and observable teeth length is lengthened in cases when vertical teeth lengths are shorter than usual and when patients have a gingival appearance when they laugh, also called as “Gummy smile”.
Free Dental Graft – Connective Tissue Graft Applications
In cases of excessive gingival recession or insufficient gingival thickness on implant areas, tissues are taken from various areas of mouth and applied to the required place. Since grafts are directly taken by the patient, its success rate is high and grafted area can recover within a short time with a good dental care.
Laser Application in Dentistry
Today, soft tissue and hard tissue lasers are used in dentistry thanks to technological developments. The most widely used between these is soft tissue lasers. They are generally used on gingiva and in relevant processes. Lasers are preferred since operation is completed without giving cause to bleeding and there is a chance for millimetric work and in order to provide a better recovery for posttreatment period. Though not widely used as much as soft tissue lasers, hard tissue lasers are used in tooth and bone processes. A doctor who intends to conduct laser application should be trained on laser application. ‘Picasso Diode Laser’ device is used in our clinics.