What does the closed and open curettage of periodontal pockets mean, the procedure of these operations, the advice of dentists

To date, very common problems with the gums.Treatment of gum disease consists of a number of different procedures that identify and eliminate the cause of the disease, and also do not allow its recurrence.Often in the treatment of gums, a procedure such as curettage of periodontal pockets is used.

What is the curettage of periodontal pockets?

The deepening between the edge of the gum and the cervical part of the tooth is the gingival( periodontal pocket).Normally the depth of such a pocket is usually about three millimeters.And in the case where the size of the pocket is larger, this is already a symptom of dental diseases.

The medical procedure used in the treatment of periodontal diseases is the curettage of periodontal pockets.During this procedure, removes the contents of the periodontal channels : granulation tissue, subgingival tartar, bacteria, their vital products, areas of softened cement of the tooth.

Technique for the procedure

In English, curettage means "scraping".However, in dentistry this purification procedure has a wider meaning.

Stages of classical curettage technique in the treatment of periodontal diseases.

1. Antiseptic treatment is carried out at the location where the procedure will be performed.
2. Anesthesia is made using application or injection equipment.
3. The surface of the tooth is destroyed and removes soft and hard deposits of ( organic plaque, stones).This is done with the help of special equipment( ultrasound) or dental instruments.
4. Scaffolding on the root of the tooth is an infected and destroyed cement and dentin.
5. The root part of the tooth is leveled and smoothed, its surface is polished.
6. With the help of the tool epithelial strands, granulations, which are damaged by infection of necrotic gum tissue, are scraped off.Scraped out from the cavity of the periodontal pocket, along with blood and mucus.
7. Purified tissues are treated with antiseptics and antibacterial drugs.
8. The gums are pressed against the root surface of the tooth and a bandage is applied on it.

If the procedure was carried out correctly, then the periodontal pocket of improves the lymph flow and blood circulation of , creating favorable conditions for the onset of physiological hemostasis.The final result of treatment is the attachment of the gum, the restoration of its epithelial covering and the lower edge of the gingival groove.

Surgical treatment methods

Open curettage of periodontal pockets

During this operation, all subgingival deposits and inflamed granulation tissues from the gum are removed, , the periodontal pockets are eliminated, the bone tissue is regenerated by means of a replanting of synthetic bone tissue.

Preparing for operation:

• dentures are removed;
• Anti-inflammatory therapy is performed;
• tooth splinting is performed( according to indications).

The operation is performed under local anesthesia, against the background of antibiotic therapy.Usually, one segment( 7-8 teeth) is processed in one operation.

Highlights of the procedure:

• exfoliates the mucous membrane of the teeth and gums, in order to get to the bone tissue.For this, a cut is made around the necks of the teeth;
• to detect defects, from the bone exfoliate the flaps of bone tissue.This allows you to see all subgingival deposits and periodontal pockets, from which, with the help of special surgical curettes and ultrasound scaler, granulation tissue and dental stones are removed;
• antiseptics treats the surface of bone tissue and the roots of the teeth.If the bone pockets are deep, then the synthetic bone "sits".This is necessary to restore bone tissue.In full, it will not be possible to restore it, but it is possible to reduce the bone pockets completely;
• in the area of ​​the interdental papillae superimposed seams.The gingival bandage, which will promote healing and protect the area of ​​the operation, is superimposed at the end of the operation.Ten days after the open curettage, the seams are removed.

Closed curettage of periodontal pockets

The purpose of this operation is to remove periodontal pockets and subgingival dental deposits.The minus of this technique is blind curettage, without a visual survey of roots and periodontal pockets.Because of this, dental deposits and granulations remain in their places.

Effective closed curettage in periodontal pockets up to three millimeters.With parodontitis, which is of moderate to severe severity, closed curettage only temporarily improves the gingival condition of by reducing the granulation mass.Periodontitis will progress further, as this phenomenon will be short-lived.

Simultaneously, a closed curettage is carried out only in the area of ​​two or three teeth.The cleared cavity heals about a week.But only after a month it is possible to carry out diagnostic sounding of the gingival groove.

This type of curettage is popular in those dental clinics where there is no experienced surgeon, and the operation is performed by an ordinary dentist-therapist.

In order to assess the condition of the gingival pockets, develop tactics for further treatment or prevention of re-occurrence of tartar, patients are instructed to visit the dentist after three to four months.