Gum incision with periodontitis: indications and procedure description

Many patients suffering from chronic inflammation of the gums, as well as periapical tissues wonder whether it is possible to recover from periodontitis. The answer can not be unambiguous. Much depends on the type of inflammation, the form of the process, the classification of the disease. Sometimes a doctor has to make a gum incision with periodontitis. To whom is this procedure shown? What is periodontitis? We will understand more in detail.

Periodontium

The connective tissue that fills the space between the tooth itself and its attachment to the alveolar processes of the jaw is called periodontium. The periodontal cleft begins at the base of the gingival membrane, and ends at the alveolar process. In different parts of the gap has a different thickness, near the middle of the root, it is the narrowest.

The periodontium contains the vessels of lymph and nerve endings, due to this nutrition of incisors and numerous collagen fibers occurs. Each fiber is formed by a large number of polysaccharides and various proteins. The main task of the structure is to ensure mobility of the tooth. To perform this task, the fiber patches must penetrate into the bone tissue.

Inflammation of periodontal disease

Inflammation of the basal membrane and connective tissues of the tooth is called periodontitis. Chronic periodontitis conceals a certain threat in itself, since the symptoms of the disease do not appear immediately. The disease can occur in patients of any age, it has no age limits.

The first and insignificant symptom of the disease is an unpleasant smell, bleeding gums when brushing your teeth. Often patients complain of some discomfort when they eat. The main symptom of the disease is localized pain, which is of a pulsating nature, grows with time and has no specific location. With a large load on the incisors the pain increases, with clenching of the teeth it grows stronger, sometimes it is impossible to consume even liquid food. This increases the body temperature. In such cases, the help of the dentist is simply necessary. In advanced cases, surgical intervention may be required. Incision of the gum with periodontitis is made in extreme cases, but often this action helps to save the tooth.

Acute periodontitis

If the sharp pain has gone to such a stage, when it is impossible to touch the tooth, the gum is swollen, often the cheek with the lip, the tooth is unsteady, and the body temperature has jumped, which means that the pulpit has completed its black mission. Your indifference led to the fact that the inflammation from the root of the incisor went beyond, captured all the tissues surrounding the tooth, acute periodontitis began. Urgently need to contact a dentist who will try to save your tooth, you may need a gum incision with periodontitis, this should not be feared. After the procedure, the doctor will explain what further needs to be done to heal the wound.

Often periodontitis can be a consequence of trauma: a consequence of unsuccessful treatment of pulpitis, after biting something solid. Dentists call to protect the incisors and never gnaw something hard.

Chronic periodontitis

Chronic periodontitis ultimately leads to the fact that the dentition is loosened, crevices are formed between the teeth, gums bleed not only during cleaning, but also in a calm state (even at night). A characteristic feature of this course is that the stage alternates between acute and chronic. For example, a patient may say that the tooth was ill, but after a while the pain stopped, often this phenomenon occurs with granulomatous periodontitis. If the disease proceeds according to this scenario, only the X-ray image helps to reveal the pathology, since the patient can feel only minor discomfort, darkening of the tooth, unpleasant odor. When examining the carious cavity with a probe after the filling, there is no pain.

An x-ray is prescribed, in the picture, a section with a rounded formation will be clearly visible. Such tissue destruction is granuloma, if its size is more than 1 cm, then it is a cystogranuloma. In chronic form, it is hardly necessary to make a gum incision with periodontitis, but the consequences of the disease are very insidious. Inflammation in the dental canal occurs in stages, pathogenic bacteria, multiplying, release a lot of toxins. Intoxication can lead to various diseases of the heart, kidneys, joints and other organs.

Methods

After revealing a chronic and acute periodontitis of teeth, treatment with a doctor is appointed immediately. This problem is solved in two ways:

• Conservative-therapeutic;
• Surgical.

An effective addition is physiotherapy, when a positive result is obtained using electrophoresis with potassium iodide, magnetotherapy, UHF on the inflamed zone, laser therapy, paraffin applications.

Periodontitis is never cured in a single step. The patient will have to visit dentistry several times before recovering completely. The order of care has certain stages.

Treatment of periodontitis: stages. Gum Slit

After the diagnosis the doctor must first of all:

• Provide an outflow of pus;
• To remove symptoms of intoxication.

To determine the degree of development of inflammation, an X-ray procedure will be prescribed. After this, the dentist will work with the affected tissues, having previously resorted to anesthesia. Fabrics can be damaged by pulpitis, carious process, negligent previous treatment.

Periodontitis will continue with the root canal dissection, where problems have arisen. With the help of antiseptics, the doctor must process them.

For unimpeded removal of pus it will be necessary to expand the apical opening of the upper part of the root of the tooth.

If the disease passes against the background of the flux, then you can not do without cutting the gums. Next, to close the root canals, the doctor uses a cotton swab.

There are several ways to treat periodontitis. In more detail, consider the extreme method - surgical.

Surgical treatment of chronic periodontitis, methods

In the treatment of periodontal inflammation, only in extreme cases do they resort to periodontal surgery. It involves full or partial removal of the tooth or root. In modern dentistry, extraction is becoming less common, to date, surgery tends to denture and has all the means to do so.

But sometimes you have to make an incision of the gum (above the tooth of wisdom, for example). This occurs in cases where it is required to produce an outflow of pus during periodontitis.

More and more often, surgeons resort to resection of apex root, not all of the apex is removed, but only the affected part. The procedure of removal takes place at the maximum pain relief, the operation is performed very quickly. It is possible not only to keep the tooth, but also to restore it with a crown or in other ways.

Using the laser method for resection can simultaneously remove granuloma, cyst. The method is sufficiently effective and bloodless. Laser technologies have found wide application in surgery of premolars, incisors, canines.

With periodontal inflammation in molars, hemisection is performed, while the tooth is sawn, the affected root is removed, while maintaining a healthy and the tooth is restored by orthopedic methods.

Gingivotomy (gum incision upright)

In some cases, it is not possible to open the tooth to produce conservative treatment, in such cases one has to resort to a cut. Often the cause of such interference may be periodontitis. After the incision of the gum there is an outflow of exudate, pus. It is also shown in the inflammatory processes of the periosteum to prevent more serious complications.

Gum incision in such cases is called gingivotomy. What are the indications for gingivotamia? They can be:

• Very deep, large, but narrow pocket of gum;
• Periodontal single large abscess;
• Marginal inflammation or one of the types of marginal periodontitis;
• Often periodontitis of wisdom tooth.

How is the incision of the gums carried out?

The process of gingivotomy occurs in stages:

• Anesthesia.
• Dissection along the entire depth of the gum in the area of the zubodesneve pocket.
• The incisions are vertical (in lateral areas).
• Seeding of flaps.
• Reclamation of the pocket. Removal of affected epithelium and granules.
• Stitching and dressing.

Treatment after a gum incision usually passes without complications, the wound is tightened fairly quickly and does not subsequently have tissue defects.

The incision is made in different ways, everything depends on the severity of the inflammation, as well as indications for manipulation. It may be decided to perform a gingivectomy (horizontal incision). In any case, for a successful surgical outcome, much attention should be paid to aseptic. Aseptic helps avoid infection of wounds, prevents pathogens from entering the surgical field. In addition, it is necessary to use sterile gloves, tools, napkins, tampons.

How the gum is healing

Healing of wounds after periodontal operations is the formation of new anatomical and physiological connections between cells and tissues. The process itself has several stages:

• After the intervention, a blood clot forms, which forms within 10 minutes, it serves as a barrier, protection from harmful microbes and infections.
• Within 3-4 hours a young connective (granulation) tissue is formed.
• The formation of collagen and epithelialization takes 7-10 days. Sometimes it can cause a slight itch.
• Maturation and regeneration lasts from 2 to 3 weeks. The wound is tightened, but complete healing does not occur until a few months later.

What to do after the procedure

Many people are wondering how to be after cutting the gums? What can I do to heal the wound quickly? After surgery, the dentist must always warn the patient how to care for the gum. But some patients do not remember a little in the "shock" state, having come home, what did the doctor advise them. So, the recommendations after the incision of the gums:

• After the surgery, the doctor will put a gauze swab in the wound to stop the bleeding. Keep it for at least 20 minutes.
• Arriving home, you need to lie down and rest a little.
• Do not follow the operation after taking food, drink any drinks for three hours. Further in the diet should be present only soft food to avoid injury to the site of the cut.
• If you experience severe pain, you can take any pain medication. On the second day after the manipulations it is necessary to start rinsing, this will avoid infection of the wound, as well as the development of inflammatory processes. You can use for rinsing "Furacilin", infusions of chamomile and sage.
• Within three days after the intervention, you should not eat hot, hard food, or open your mouth wide.
• Limit all physical, emotional stress.
• Under the prohibition of classes in the gym, sauna, hot tub.
• For a week it is better to give up smoking and alcohol.
• Do not cauterize the wound with green tea or iodine. Do not use anything hot. So you will only make it worse!
• A dentist can appoint applications for a wound of antimicrobial and wound-healing drugs (Solcoseryl, Holisal, Stomatophyte).
• To strengthen immunity, it is possible to take multivitamin complexes and immunomodulating agents.
• To control the healing after five days, it is worth to consult a doctor.