Пародонтология хирургия , микрохирургия

Periodontal surgery: microsurgery.

 Microsurgical periodontics is an innovative technology and a new surgical protocol in the field of modern dentistry.  Today, various gum diseases are successfully treated with modern, effective and painless methods.  But when the situation is complicated and severely neglected, the inflammatory process captures a large area of   tissue and, accordingly, penetrates to a considerable depth.  In such situations, therapeutic treatment is no longer effective; periodontal microsurgery is replacing it.

Treatment of periodontitis using microsurgical methods.

Microsurgery is a small surgical procedure using a microscope, which implies a build-up of missing tissue in the gum area.  It can also be used in case of excessive growth of soft tissues.  Microsurgery implies minimal tissue trauma, quick recovery and maximum effect as a result of the procedure.

When is it recommended to use microsurgery:

  • The presence of pathologies that have already spread to a large area of tissue.
  • The need to restore bone tissue.
  • Significantly deep gum pockets.
  • Preparation for prosthetics.
  • Aesthetic significant defects.
  • Profuse bleeding of the gums.
  • Hyperplasia of the gums.
  • General tissue thinning
  • Noticeable exposure of the tooth neck (gum recession)
  • Strong mobility of teeth in the bone.

 Microsurgery of the gums for periodontitis can solve not only the aesthetic problem of the patient, but also stop the development of periodontitis

Advantages of using periodontal microsurgery:

  • minimal trauma to soft tissues
  • quick rehabilitation after the procedure
  • no contraindications for age
  • the possibility of using in the presence of various chronic diseases
  • Micro-fine seams or lack thereof.

Flap operations

 In most cases, periodontal microsurgery is performed using flap operations.

 Flap surgery is a dental procedure using minimal surgical interventions, which allows for effective cleaning of plaque from deep periodontal pockets.

How does the operation take place?

 First, a flap is carefully incised from the gum adjacent to the diseased tooth, then cleaning is performed, and then the flap of tissue is returned to its place.  The procedure is carried out with the introduction of an anesthetic, so the patient does not feel pain at all, and the quick healing time allows not to experience any special discomfort.

 Stages of the procedure:

  • neat cutting of the gums to create a flap;
  • exfoliation of the separated epithelial and connective tissue;
  • thorough cleaning of the periodontal pocket;
  • attachment of the flap back with suturing.

 The same applies to periodontal surgery:

  • closure of gum recession.
  • open curettage;
  • an increase in the area of keratinized gums (plastic surgery of the gums or gingivoplasty);
  • deepening of the vestibule of the oral cavity (or vestibuloplasty);
  • plastic surgery of the frenum of the tongue.

Closing the gum recession

Gum recession, in other words, is the process of exposing the neck of the tooth.

 Causes of gum recession: periodontitis and periodontal disease, functional overload of the dentition, errors in orthodontic treatment.

 The treatment of gum recession occurs using the method of flap operations or using a laser.

 How to prevent gum recession:

  • Thorough home hygiene.
  • Regular visits to a specialist for comprehensive cleaning examinations every 6 months.
  • Do not ignore the sensitivity and bleeding of the gums.
  • Do not develop dental caries and consult a dentist on time.
  • Timely correct malocclusion.
  • Do not abuse bad habits (seeds, smoking, etc.).


Open curettage

The indication for open curettage is moderate periodontitis and if the depth of the periodontal pocket reaches more than 5 mm in depth, also in the presence of bone pockets.  It implies a more serious surgical intervention under the gums and is carried out under local anesthesia.

 Open curettage stages:

 1) Detailed and thorough diagnostics, examination by a periodontist. At this stage, the specialist determines the depth of the periodontal pocket, the degree of periodontitis, and draws up a competent further treatment plan.

 2) Individual selection of local anesthetic based on the characteristics of the body and indications.  Implementation of local anesthesia.

 3) Surgical intervention: the doctor makes two small incisions in the gum and gently peels it off the tooth.  This allows the periodontal pocket to be accessed and thoroughly cleaned.

 4) Grinding and polishing the surface so that bacterial plaque does not form in the future, after which the gum is carefully sutured.

Plastic surgery of the gums or gingivoplasty

Plastic surgery of the gums or gingivoplasty: recommended for use in case of a lack of gum tissue around the tooth or implant, with strong tooth mobility.  The task of gingival plastics is to restore the quality and quantity of gum tissue. The procedure is performed with local anesthesia.  In 95% and more cases, the patient's own tissues are used for this manipulation.  (Read more on this topic in a separate article).


 Vestibuloplasty or deepening of the vestibule of the oral cavity: in other ways, this is an operation aimed at deepening the vestibule of the oral cavity with its insufficient size, while expanding the area of   the attached gums.  The normal depth of the vestibule is considered a depth of 5 to 10 millimeters.  Deepening less than 5 millimeters is considered abnormal development of the muscles and tissues of the mucous membrane.  This can lead to dental problems. Small vestibule can be both congenital and acquired.  (Read more on this topic in a separate article).

Tongue frenum plasty

 Tongue frenum plasty: an operation aimed at correcting the improper attachment of the frenum (in most cases, it is carried out in childhood).  The specialists of the Sa-Nata network of clinics most often perform this operation using a special laser, which helps to avoid complications and allows the operation to be performed quickly and painlessly.

 Indications for the use of bridle plastics:

  • Marked limitation of tongue mobility.
  • Difficulty swallowing and eating.
  • Disturbance of normal breathing.
  • Formation of an irregular bite.
  • Displacement of the front teeth back.
  • Violation of the proportions of the face, curvature of a mimic smile.
  • Difficulties in rhetoric.

 (Read more about each type of microsurgery in separate articles on these topics on our website).

 We would like to draw your attention to the fact that nothing is impossible for the specialists and professionals of the network of clinics "Sa-Nata"!  Our many years of experience, an integrated approach, modern equipment and, of course, love for people and a desire to help allow us to carry out dental procedures of any complexity! 

If you are in “SA-NATA”, then you are in good hands!