What advances have increased the predictability of esthetic periodontal surgery?

Improved root preparation techniques have greatly advanced grafting procedures. Enhanced magnification and illumination provide for superior visual acuity. Smaller instruments, needles, and sutures allow for precise surgical margins and minimal tissue trauma. The result of these advances has been shorter healing times, absence of scarring, and an esthetically pleasing blending of gingival contours and color.

The photographs above vividly illustrate the esthetic advances in periodontal plastic surgery. This patient had an existing gingival graft. Notice the superior color and contours of the healed connective tissue graft.

Why are restorative dentists increasingly recommending periodontal plastic surgery for their patients?

In recent years, the demand for cosmetic dentistry has steadily increased. This has been accompanied by higher patient expectations for an esthetically pleasing final result. Even the finest restorative treatment can be an esthetic disappointment if the periodontal component is not factored into the total treatment plan.

With sophisticated surgical procedures, the periodontist can provide an ideal gingival frame for restorative dentistry. General dentists, prosthodontists, and orthodontists are increasingly coordinating treatment with the periodontist to achieve the highest level of health, symmetry, and esthetics. Often a collaborative effort can be the difference that makes the difference in patient satisfaction.

What is the appropriate treatment sequence for esthetic periodontal procedures?

Preprosthetic communication between the periodontist and the restorative dentist is necessary.

Periodontal procedures are usually completed prior to the initiation of restorative treatment. In some cases periodontal surgery is appropriate while the patient has provisional restorations. Periodontal procedures should be completed before impressions are taken for final restorations.

What is the expected longevity of Esthetic Periodontal Surgery?

The long-term stability of periodontal plastic surgery is excellent. As with other periodontal procedures, long-term success is greatly enhanced by regular professional maintenance, effective plaque control and a stable, atraumatic occlusion.