Today, gum problems are very common. Treatment of gum disease consists of a number of different procedures that identify and eliminate the cause of the disease, as well as prevent its recurrence. Often in the treatment of gums apply such a procedure as curettage periodontal pockets.
Content
What is periodontal curettage pockets?
Deepening between the edge of the gum and the cervical part tooth is gingival (periodontal pocket). Normally, the depth of such a pocket is usually about three millimeters. And in the case when the size of the pocket is larger, this is already a symptom of dental diseases.
The medical procedure used to treat periodontal disease is curettage of periodontal pockets. During this procedure the contents of periodontal channels are deleted: granulation tissue, subgingival dental calculus, bacteria, their waste products, areas of softened tooth cement.
Procedure technique
Translated from English, curettage means "scraping." However, in dentistry, this cleansing procedure has a broader meaning.
The stages of the classical curettage technique in the treatment of periodontal diseases.
- Processing antiseptics in the place where the procedure will be carried out.
- Anesthesia is done using application or injection means.
- From the surface of the tooth are destroyed and soft and hard deposits are removed (organic plaque, stones). This is done with the help of special equipment (ultrasound) or dental instruments.
- Scraped to the root of the tooth affected and destroyed by infection of cement and dentin.
- The root part of the tooth is leveled and smoothed, its surface is polished.
- Using the tool, epithelial cords, granulations, which are damaged by infection of necrotic gum tissue, are scraped off. The scraped is removed from the cavity of the periodontal pocket along with blood and mucus.
- Peeled tissues are treated with antiseptics and antibacterial drugs.
- The gum is pressed against the root surface of the tooth and a bandage is applied to it.
If the procedure was carried out correctly, then in the periodontal pocket improves lymph flow and blood circulationFavorable conditions are created for the occurrence of physiological hemostasis. The final result of treatment is the attachment of the gums, the restoration of its epithelial cover and the lower edge of the gingival sulcus.
Surgical treatments
Open curettage of periodontal pockets
During this operation, all subgingival deposits and inflamed granulation tissues are removed from under the gums, periodontal pockets eliminated, with the help of synthetic bone grafting, bone tissue is regenerated.
Preparation for surgery:
- removed dentures;
- anti-inflammatory therapy;
- held teeth splinting (according to indications).
The operation is performed under local anesthesia, on the background of antibiotic therapy. Usually, one segment (7-8 teeth) is processed in one operation.
The main points of the procedure:
- exfoliate the mucous membrane of the teeth and gums, in order to get to the bone tissue. For this, an incision is made around the necks of the teeth;
- bone flakes are peeled off from the bone to detect defects.This allows you to see all subgingival deposits and periodontal pockets, from which, with the help of special surgical curetum and an ultrasonic scaler, granulation tissue and tartar are removed;
- antiseptics treat the bone surface and tooth roots. If the bone pockets are deep, then synthetic bone is “planted”. It is necessary for the restoration of bone tissue. It will not be possible to fully restore it, but you can completely reduce bone pockets;
- in the area of interdental papillae sutures are imposed. A gum bandage, which will promote healing and protect the area of operation, is applied at the end of the operation. Ten days after the open curettage, the sutures are removed.
Closed curettage of periodontal pockets
The purpose of this operation is to remove periodontal pockets and subgingival dental plaque. The minus of this technique is blind curettage, without a visual review of the roots and periodontal pockets. Because of this, dental plaque and granulation remain in place.
Effective closed curettage with periodontal pockets up to three millimeters. With periodontal disease, having a moderate and severe degree, closed curettage is only temporarily improves gum condition by reducing the mass of granulation. Periodontitis will progress further, since this phenomenon will be short-lived.
At the same time, a closed curettage is performed only in the area of two or three teeth. The cleaned cavity heals for about a week. But only in a month can be carried out diagnostic probing gingival groove.
This type of curettage is popular in those dental clinics where there is no experienced surgeon, and the operation is performed by an ordinary dentist-therapist.
In order to assess the condition of the gum pockets, to work out the tactics for further treatment or prevention of re-occurrence of tartar, patients are ordered to visit the dentist after three to four months.
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