Surgical periodontal treatment
In some more advanced cases, a surgical intervention is sometimes necessary. This corrective phase complements the etiological treatment when the expected results are not fully achieved.
After reevaluating the response to the initial treatment, the periodontist may recommend surgery to improve outcomes and stabilize the periodontal condition.
In all cases, we favor a non‑surgical treatment if the prognosis is equivalent.
Objectives of a surgical periodontal treatment
Such an intervention allows, in particular, to:
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- Access deep root surfaces (periodontal pockets)
- Remove subgingival calculus, often unreachable without surgery
- Reduce deep inflammation
- Decrease the depth of periodontal pockets
- Promote regeneration of periodontal tissues
Common Surgical Techniques
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Open flap periodontal surgery
This technique enables reaching areas inaccessible by instruments used in non‑surgical treatments, including:
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- Root surfaces located between teeth
- Lesions located between roots of premolars or molars
In addition, we may reshape the bony contours to reduce periodontal pockets and improve the local anatomy.
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Induced tissue regenerative periodontal surgery
This approach first involves deep cleaning of the affected zones, as in the sanitation surgery. Then, we apply enamel‑derived porcine proteins (amelogenins). These biomaterials stimulate natural regeneration of periodontal tissues — ligament, alveolar bone, and cementum.
Clinical case
Regenerative periodontal surgery
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Guided tissue regeneration surgery
The goal of this surgery is to access zones inaccessible by non‑surgical treatments, then to place a membrane to control tissue regeneration.
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Crown lengthening surgery
The goal of this surgery is to restore the biological width so that the gums can attach to the teeth over a sufficient height. Bone is modeled and the gums are repositioned. This surgery also allows correction of gum position relative to the smile line when placing an aesthetic ceramic prosthesis.
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Pre‑prosthetic Surgery
The aim of this procedure is to optimize the periodontal condition prior to prosthetic placement.
Molar roots may be removed, biological spaces restored, bone remodeled, and gingival tissue thickened and repositioned.
Clinical case
Pre‑prosthetic Surgery
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Mucogingival (or periodontal plastic) Surgery
The aim of this surgery is to rebuild and reposition soft tissues and gums. The methods primarily used are gum grafts. Currently, the most used graft that produces the best results is the submerged connective tissue graft. Only the internal part of the tissue is harvested and transplanted beneath the poorly positioned or overly thin gums.
Periodontal maintenance
Once the disease is treated, supportive or maintenance treatment is essential to preserve periodontal health.
These sessions allow control and prevention of new pocket formation. They permit deep cleaning to improve hygiene techniques and reduce plaque and deposits hard to reach for patients. These maintenance sessions typically occur every three to four months.
Periodontal disease is treatable. The key to success is to follow the treatments recommended by your periodontist and remove the bacterial plaque that can trigger disease progression via good oral hygiene.