Gingival flap surgery

Gingival flap surgery is a relatively common method of treating dental diseases. It mainly refers to separating the gums from the underlying tissue through a surgical incision, and then forming a gingival tissue flap. This allows for debridement and observation of the specific diseased area, as well as the removal of diseased tissue and plaque and tartar, thereby thoroughly treating some dental diseases. Let us now learn about some of the contents of this surgery.

Indications for surgery

1. After basic treatment, there are still deep periodontal pockets of more than 5mm or complex periodontal pockets, with inflammation of the pocket wall and bleeding after probing; 2. Deep periodontal pockets with the bottom of the pocket exceeding the membrane-gingival joint (the membrane-gingival joint refers to the junction of the gums and the alveolar bone mucosa); 3. Alveolar bone defects require bone repair or bone grafting, periodontal tissue regeneration treatment; 4. Patients with root bifurcation lesions accompanied by deep periodontal pockets or periodontal-endodontic lesions.

Timing of surgery

After basic periodontal treatment such as cleaning, scaling, and root planing, patients should undergo a reassessment of their periodontal condition. Generally, a comprehensive periodontal examination is performed 6 to 8 weeks after treatment, and necessary X-ray examinations can be performed 3 months after treatment to evaluate the patient's response to basic treatment and to understand whether the patient can cooperate well, effectively control plaque, quit smoking habits, and regulate overall health status. Then, based on the results of the examination, a decision will be made as to whether periodontal flap surgery should be performed.

Contraindications to surgery

Like all periodontal surgeries, when the periodontal condition is reassessed 6 to 8 weeks after basic treatment, periodontal flap surgery should not be performed if the patient has the following conditions. 1. Patients do not pay attention or cannot perform good plaque control due to disabilities. Because good plaque control is one of the decisive factors for the success of periodontal surgery. A study published by Lindhe et al. in 1984 showed that during a 5-year observation period, the stability of the therapeutic effect of patients who underwent periodontal flap surgery but did not effectively master plaque control methods and had poor plaque control was significantly lower than that of those with good plaque control. 1. The patient suffers from systemic diseases that are not effectively controlled. Patients with diabetes or blood diseases that are not effectively controlled, or those who have suffered cardiovascular or cerebrovascular accidents within the past six months, are not suitable for surgical operations due to their general condition. Surgery on such patients may result in bleeding, infection, or pose a risk to their overall health or even their lives. 2. The smoking patient has not quit smoking. A review published in 2012 by Javed et al. [2] showed that smoking has adverse effects on the healing and efficacy of patients undergoing surgical treatment. Patients who smoke should be advised to quit smoking and undergo surgical treatment only after they have quit smoking.