When is open access needed?
When the pocket depth is more than 5 mm, closed curettage no longer allows to completely clean the root surface - the doctor works blindly. Open access provides an overview: both subgingival stone and bone defects are visible. After cleaning the roots and removing granulations, bone material is placed into the defect, if necessary, and the gum is sutured with a tight fit to the teeth. The stitches are removed after 7–10 days.
Why periodontitis needs to be treated
Periodontitis is a chronic inflammation of the tissues that support the tooth. It begins with bleeding gums and ends with loss of bone tissue, exposed roots and mobility of teeth. It is the most common cause of tooth loss in adults—more common than tooth decay.
Bone tissue that has already been lost does not regenerate on its own. Therefore, the goal of treatment is to stop the process and preserve what is there, and, if possible, restore the lost volume surgically.
What does treatment consist of?
- professional hygiene - removal of plaque and tartar above and below the gums
- closed curettage - cleaning pockets without an incision at a shallow depth
- open curettage and flap operations - for deep pockets
- plastic surgery of soft tissues – for gum recession and short frenulums
- splinting - stabilization of mobile teeth
- maintenance therapy - control every 3-6 months
What depends on the patient
No operation will produce results without daily hygiene. A brush, dental floss or brushes and an irrigator are a mandatory minimum. Smoking significantly worsens the prognosis: in smokers, inflammation is more secretive, and healing after interventions is slower.