Gingivectomy

This refers to the surgical removal of excess gum tissue for aesthetic or functional reasons. Excessive gum tissue may be a natural occurance or it may be caused by gum overgrowth secondary to some medications. Some drugs used in the treatment of epilepsy, high blood pressure and immunosuppression are known to cause excessive tissue overgrowth. It is important to note that use of these drugs should not be discontinued even if they cause gum related problems. A gingivectomy procedure can improve the aesthetics of the teeth if the patient has a gummy smile, and it will also facilitate daily oral hygiene.

Frenectomy

This refers to removal of the small web of tissue that attaches from the inner lips to the gum tissue. These webs of tissue are found in every mouth, and in most cases they are quite small and do not represent a problem. Occasionally they can be large, and they may interfere with orthodontic therapy. They may contribute to gap formation between the incisor teeth and also, if they attach close to the gum margin, they can lead to worsening gum recession and inflammation. Minor surgery can be performed to remove this tissue. The resultant wound normally heals very quickly and without complication.

Gum Grafting

This procedure is usually indicated to treat gum recession problems. Gum recession may be caused by previous gum disease, over-zealous tooth brushing (particularly with a hard tooth brush) or occasionally following other dental therapy, such as orthodontic treatment. The graft can usually be sourced in one of two ways. A graft may be taken from another site in your mouth, usually from the palate, or a graft may be sourced from a human tissue bank. This donor tissue is extensively treated and processed, so that a collagen scaffold is all that remains.

Once this tissue is surgically applied on the recession defect, it gradually gets replaced by your own tissue. This type of donor tissue is used in other types of plastic surgery procedures, e.g. in the treatment of burns. For most patients this is generally considered to be a very successful procedure, but the extent of defect coverage will depend on the extent of the original condition, the control of causative risk factors and the subsequent hygiene of the area.

Crown Lengthening

This refers to a surgical procedure to expose more of the tooth by removal of some bone and gum tissue from around the tooth. It can be employed to treat a ‘gummy smile’ when the patient considers their smile to be unattractive as they display too much gum tissue. It can also be used to harmonise gum margins if they are uneven, or if the tooth has a fracture or decay that extends below the gum line, that would make it difficult or impossible for the dentist to otherwise treat.

Bone Grafting

As its name suggests, it involves placing a bone graft in a site where there is a deficiency in bone volume. The most common application for this procedure is prior to dental implant placement, but it can also be used in selected cases to reverse the effects of bone loss secondary to gum disease. The bone graft itself can take several forms, and the choice of material is to a large degree dictated by the location and size of the bone defect, and the purpose of the graft.

Periodontal Flap Surgery

This type of surgery may be considered when, after initial non-surgical therapy for gum disease, there remain some sites in your mouth where the disease continues to progress. These areas are usually referred to as ‘deep pockets’. The aim of this surgical procedure is to create an environment around the relevant tooth or teeth, where the gum tissue has a better chance of healing and to make it easier for a patient to carry out their daily oral hygiene regimen. The ideal outcome would be elimination of the deep pocket. This surgery may involve excision of excessive gum tissue, recontouring of the underlying bone and possibly regenerating some of the lost bone with the use of some grafting techniques.