What is Flap Surgery?

Flap surgery which is also known as pocket depth reduction can be described as the loosening of the gum from bone to expose and clean underlying tooth structures. In advanced periodontal disease, when scaling and root planing have been unsuccessful in eliminating the entire pocket of decay, or when there has been bone loss that needs to be surgically corrected, then a dentist may perform periodontal flap surgery.

When is Flap Surgery done?

Periodontal Flap surgery is recommended in many cases where pocketing depths have reached a level that makes maintenance or cleansing difficult. It is often associated with areas of bone loss and inflammation of the gum tissue around the teeth. 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.

Process:

When scaling and root planing have been unsuccessful in eliminating the entire pocket of decay, or when there has been bone loss that needs to be surgically corrected, then a dentist may perform periodontal flap surgery. In flap surgery, after numbing the area with a local anesthetic, the periodontist will use a scalpel to separate the gums from the teeth and then lift or fold them back in the form of a flap. This gives the periodontist direct access to the roots and bone supporting the teeth. Inflamed tissue is removed from between the teeth and from any holes (defects) in the bone. In order to clean plaque and tartar, scaling and root planning is done. In case of any bone defects, the periodontist may eliminate them with a procedure called osseous recontouring, which smoothes the edges of the bone using files or rotating burs.
 

The dentist removes diseased tissue and smoothes the surface of damaged bones, after scraping away the bacteria-laden plaque and tartar. After these procedures are completed, the gums will be placed back against the teeth and anchored in place using stitches. Some periodontists use stitches that dissolve on their own, while others use stitches that have to be removed a week to 10 days after the surgery. Periodontist may also cover the surgical site with an intra-oral bandage known as a periodontal pack or dressing. Then the dentist sews the tissue back into place. Mouth rinses are commonly prescribed following periodontal surgery. Although these rinses do not remove plaque from the teeth, they kill the bacteria and help the mouth heal. Post-surgical swelling is also possible, and this can be minimized by applying an ice pack to the outside of your face in the treated area