text: Surgery has been one of the most common procedures performed in orthodontics. Periodontal surgery, also known as endodontic surgery, is a dental (rejuvenating) surgical treatments designed to replace and restore lost and damaged normal shape and function of the gums (the periodontal ligaments, bone and gum tissue), which support the tooth (the root). Missing teeth can be a result of damage caused by decay, trauma, or tooth loss; diseases such as gingivitis or periodontitis; or other circumstances. Regardless of the cause, tooth loss is a serious condition that must be addressed promptly with an orthodontist. Periodontal surgery relieves many conditions such as:
  Patients who have had periodontal surgery typically experience some degree of post-operative pain and swelling. Depending on the procedure, the amount of pain and swelling vary, from mild to moderate to severe. Patients who have opted for periodontal surgery must frequently visit their orthodontists to obtain relief from this symptom. Some periodontal surgery procedures include: Flap Surgery, which is done under general anesthesia in a dental office; Local Anesthetic, which requires a local anesthetic on the affected portion of the mouth and can be administered through the use of a dental handpiece; or Tissue Expander, which involves the use of a tissue expander that is designed to introduce tissue into the bone space that has been lost.
  The success rate for periodontal surgery patients is between sixty and ninety percent. Patients who have failed in the past with similar long-term treatments are not necessarily less competent than those who succeed. Failure can occur for numerous reasons such as improper periodontal disease management, poor oral health prior to treatment, or underlying disease. The treatment success depends on the severity of the underlying disease and how the periodontal surgery was performed. Success rates can be compared among different periodontal surgery groups to determine the best course of treatment.
  During periodontal surgery, the tissues and bones are “flipped” so that they will lie in the gap created by the teeth. This slippage is the reason for the discomfort experienced by most patients. Flippage will also cause bone loss, especially of the supporting bones around the tooth. If not addressed, this can cause the jaw to shift forward, compromise adjacent teeth, and cause difficulty breathing. Flippage will further increase bacteria growth, eventually leading to gum disease.
  Periodontal disease typically requires a regular evaluation and professional cleaning regime followed by a thorough flossing and irrigation. Flossing and irrigation procedures should always be done by the same periodontist or dental surgeon. If you do not already have a periodontist or dentist, ask your current dentist about a professional who could perform the surgical procedure on your behalf. The periodontist or the surgeon will make the initial evaluation and instruct you on post-operative care. Patients usually return to work the next day following surgery and can resume normal daily activities immediately.
  The root planing procedure removes plaque from deep between the teeth. Plaque is composed of different types of food that can build up between the teeth and gums. Once the plaque reaches a point where it obstructs the gums, tooth decay and inflammation may occur. Through root planing, the surgeon or periodontist can remove the plaque and kill off the bacteria that produces it.