Gingival flap surgery, also known as pocket reduction surgery is the surgical procedure done to restore the gums and bone in case of periodontal diseases which are non-responsive to non-surgical treatment.

A gum specialist (periodontist) or an oral surgeon often performs the procedure.


Indications of Gingival Flap Surgery

Gingival flap surgery is used to treat gum disease (periodontitis).It may be recommended for people with moderate or advanced periodontitis, especially if the initial, non-surgical treatment (scaling and root planing) has not eliminated the gum infection. It may also be done in conjunction with another procedure known as osseous (bone) surgery.


Objectives of Gingival Flap Surgery

The objectives of gingival flap surgery are to:

  1. Eliminate or reduce pockets.

  2. Regenerate periodontal tissues and their (re)-attachment to the teeth.

  3. Create more normal periodontal form, function, and aesthetics;

  4. Promote an environment more conducive to good oral hygiene practices and professional maintenance care.


Preparation

Periodontist or dental hygienist will first remove all plaque and tartar (calculus) from the  teeth and makes sure that the patient’s oral hygiene is good. Before flap surgery, the periodontist will determine whether the patient’s general health or current medications allow for a surgical procedure to be carried out or not.


Surgical Procedure

After the administration of the local anesthesia, the soft tissue is incised with surgical knives on both sides of the tooth or teeth to be treated. The incisions are made vertically in such a way that the base of the flap is broader. The incised soft tissue flap is reflected away from the tooth crown to expose the underlying root and bone. The periodontal problem for which the surgery is being performed is then treated. This may involve beveling a rough root or bone spike. Any diseased or necrosed tissue is scooped out and removed. The reflected flap is then sutured back to its original position.


Follow Up after the Gingival Flap Surgery

The patient must visit the Periodontist for follow up. Sutures placed on the surgical site are removed after one week. The Periodontist may need to vary the dose of antibiotics and pain killers according to the condition of the patient. The patient must check with the dentist if he or she is sufficiently maintaining proper oral hygiene to prevent any infection. Patients must use a mouthwash  containing Chlorhexidine to minimize the chances of infection around the wound site. These rinses kill bacteria, delay plaque growth and help your mouth to heal. The patient is advised to brush with an extra soft periodontal surgical tooth brush for about 3 to 4 weeks or till the wound is completely healed. Swelling present after gingival flap surgery can be reduced by applying an ice pack to the outside of the face in the treated area.The patient must visit the Periodontist if:

  1. Tthe surgery area bleeds profusely even after 24 hours of the surgery
  2. The pain persists despite taking prescribed painkillers
  3. Any discharge occurs from the surgical area, or there is any swelling or infection of the wound

Risk Factors associated with Gingival Flap Surgery

After the surgery, there may be some bleeding and swelling. There is a risk of development of an infection in some cases.
The gums in the area that was treated are more likely to recede over time. The teeth that were treated may become more sensitive to hot and cold. The teeth also are more likely to develop cavities in the roots.


 

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