Is the field of dentistry that deals with the structures that support the teeth i.e. gums, periodontal ligament and alveolar bone. It is very important that proper oral hygiene is practiced to keep these structures free of plaque and calculus. Plaque is a biofilm formed by the accumulation of bacteria on the surface of the tooth. This plaque elicits an immune response and especially when certain risk factors like Diabetes, smoking,etc are present causes inflammation of gums or gingivitis which may present as bleeding gums. If left untreated the infection progresses to the underlying periodontal ligament and bone leading to the formation of periodontal pockets and loose or mobile teeth.
Gingival curettage is a surgical procedure wherein the diseased lining of the periodontal pocket is scraped and removed using laser or manually leaving behind only connective tissue. This promotes formation of a new connective tissue attachment. This procedure is done in conjunction with scaling and root planning. It is indicated when the pocket depth is 3mm or less. These days LASER is routinely used for gingival curettage. This has several advantages over the traditional methods. LASER curettage is a conservative and non-surgical option that minimizes the need for local anesthetics and ensures faster healing. It also seals the blood vessels and nerve endings thus bleeding and post-operative pain are much reduced.
In more severe cases of periodontitis which cannot be cured with antibiotics or gingival curettage, more extensive treatment may be required. Flap surgery involves cleaning on the roots of the teeth and repairing the damage to the alveolar bone if needed. The dentist first anaesthetizes the area to be treated. Then a section of the gums is pulled back to visualize the root surface to be cleaned. All the tartar and bacterial products are removed and the bone is re-shaped to make it less hospitable for plaque accumulation. A bone graft from another part of the body or a chemically formulated material may be used to promote growth and healing of the bone. The gum is sown back into place. Complete healing takes a few days. A properly done flap surgery with the right oral hygiene maintenance halts the progress of the gum disease.
Research shows that using LASERs as an adjunct to conventional surgical techniques in gum surgeries improves the effectiveness of the surgical procedures. Lasers offer a better treatment than surgery alone with much less pain, bleeding, swelling and discomfort. There is no cutting and suturing involved. This greatly reduces the healing time. The time duration of the surgery is also reduced.
The diode laser commonly used in dentistry has a wavelength of 810-900nm and is absorbed by red colored tissue like the gums. When the laser beam is passed inside the periodontal pocket it removes the layer of infected tissue from the gum side and cleans the tooth surface of the disease causing micro organisms. This leaves the gum in contact with the tooth surface, both of which are now germ free, thus promoting healing.