Periodontics is the branch of dentistry that deals with the health of tissues supporting the dental elements: above all the gingival tissue, the periodontal ligament and the alveolar bone. Since a correct therapy results only from a correct diagnosis the correct assessment of the patient’s periodontal state is the main feature of this discipline. Diagnosis is performed by collecting several data:
- A “periodontal status”: a series of intraoral X-rays (16 to 21 for a complete denture)
- The “charting”: probes with markings are used to “map”, all around the tooth, the quantity of supporting tissue that was lost. Tooth mobility and the gum inflammatory status are measured too.
All these data are entered into a software that generates a set of plots, showing the real-time periodontal health status of the patient. This allows to perform a correct diagnosis and implement the proper therapies, while assessing their results and effectiveness over time.
Periodontal therapies envisage either non-surgical or surgical treatments. In simpler cases, non-surgical treatments consist in removing sub-gingival tartar (causing the periodontal disease), and the inflammatory tissue inside the periodontal pockets (by scaling, root planing and curettage). In more severe cases, surgery must be performed: many techniques can be applied. They all aim to restore the morphology and the architecture of the tooth supporting tissues, to recover a healthy state and the use of the otherwise compromised dental element.
Sometimes, periodontal surgery is carried out even if no periodontal disorders are present, as it happens when the gummy smile needs correction for aesthetic purposes.
Pre-prosthetic surgery is a sub-branch of periodontal surgery. It encompasses all the procedures aimed to modify the periodontal tissues in order to place a dental prosthesis properly. For example, if a dental crown is destroyed but the periodontal support is still working, sometimes the gum and the bone level can be lowered to uncover a portion of the healthy tooth, to which a complete crown will be connected (clinical crown lengthening).
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