In certain cases, gum plastic after implantation may be required. Specialists recommend doing this for any mucosal defects and have the ability to adjust the volume and position of the soft tissues around the teeth. During tooth implantation, the patient, as a rule, is guaranteed a beautiful smile and tooth functionality. However, there are cases when, after such an intervention, it is additionally necessary to remove the aesthetic defect. In the article, we will consider in detail how a surgical operation for gum plastic surgery is performed, what kind of procedure the indications and contraindications are for. They will also provide expert advice and describe possible complications after the intervention.
Why is this operation performed?
After implantation, gum repair is also called gingivoplasty. This manipulation can be carried out both after implantation, and simultaneously with it, as well as in other cases of acquired or congenital pathologies of formation.
A periodontist should be engaged in this method of gum correction, which, even before surgery, determines how the gum should look in the end. To do this, he makes marks on the teeth, according to which the gum edge is supposed to end.
Why may gum soft tissue plastic be implanted after implantation?
Normally, soft tissues should fit snugly to the bottom of the tooth crown, covering the root and neck of the tooth. However, complications and impaired gum growth may occur during implantation:
- after suturing of the tissues, the gum is significantly stretched, and the healing process takes place with the development of obvious defects;
- if the temporary prosthesis is placed incorrectly, this contributes to constant pressure on the gum, slowing its growth and healing;
- during the period of restoration of the mucous membrane of the oral cavity, the patient does not make the necessary efforts to care for her, does not adhere to medical recommendations, which leads to deformation and injuries;
- at one stage of the operation, damage to the soft tissues was allowed;
- the implantation procedure was performed after a prolonged absence of a natural tooth, which contributed to gum recession and loss of the alveolar ridge.
It must be understood that the lack of tissue around the tooth, and even more so near the implanted implant, provokes very serious consequences. In this case, not only the aesthetics of the front teeth is disturbed, but also the infection in the mucosa develops, which can result in a variety of diseases or rejection of the implant. With this in mind, you should not leave such a defect unattended for a long time. Gum repair after implantation is a simple way to restore its full volume, normalize its functionality. It allows you to cure periodontal pockets and achieve a good aesthetic effect.
Varieties of procedure
Depending on how the surgical procedure is performed, a complete, patchwork, simple or separate gum repair is given after implantation. In each case, special actions of the specialist are supposed, and the condition of the soft tissues of the patient is taken into account.
By localization, the operation can cover most of the series (generalized plastic) or just one unit (localized). There is also a certain classification of correction of gingival growth defects according to the clinicians who proposed their own method - according to Kalmi, according to Egorov, patchwork according to Lukyanenko.
Indications and contraindications for this surgical operation
The most common cases when gum repair after tooth implantation can be considered a good choice during therapy:
- excessive layering of soft tissues on implants, otherwise such a defect is called a “shark smile”;
- exposure of the tooth root;
- if different levels of the gums are formed in separate areas and thereby spoil the visual appearance of the smile;
- with the appearance of the inflammatory process after implantation;
- in the presence of periodontal pockets developing as a result of periodontal disease or other diseases of the mucosa;
- with congenital pathologies of growth and location of the bridle.
However, it is not always possible to carry out such an intervention and carry out truncation of the gums or its extension. There are a number of contraindications for this:
- bleeding disorders;
- the presence of malignant tumors;
- diabetes;
- problems with the musculoskeletal system;
- alcohol intoxication or drug addiction;
- allergic reactions to a specific component of the selected anesthesia;
- respiratory pathology.
Preparing for gum repair
Since gingivoplasty involves surgery and the use of local or general anesthesia, you must first prepare for such a process. The patient is sent for a series of laboratory tests and the collection of status indicators:
- general blood analysis;
- determination of the Rhesus factor;
- prothrombin and sugar levels;
- blood coagulability;
- ECG;
- the presence of HIV infection;
- coagulogram.
At this stage, the patient should warn the dentist about the tendency to develop allergic reactions, sensitivity to medications, taking any medications or the presence of certain pathological conditions of a systemic nature.
Immediate preparation should consist of abstinence from alcohol for a week before the surgery and from food two hours before it. Dentists also recommend a preliminary course of taking vasoconstrictor medications in order to avoid the development of heavy bleeding during surgery.
The specialist requires actions:
- to prevent infection in the operated area, which is the implementation of professional cleaning, removal of tartar and plaque;
- to prevent the development of the inflammatory process in the soft tissues;
- to reduce bleeding.
When gingivoplasty is prescribed for the treatment of periodontal pockets, it is also necessary to conduct a preliminary examination of these areas and assess the condition of the soft tissues. Proper preparation significantly increases the chances of success of surgical intervention and minimizes any negative consequences.
Gingivoplasty methods
Since the development of exposure of the roots and a decrease in the volume of the mucosa are most likely to occur after dental implantation , it is often the patchwork operation for gingival extension that is often chosen . It involves the following steps and actions of a specialist:
- anesthesia is usually performed, usually local, although in certain cases general anesthesia may be preferred;
- a thorough antiseptic treatment is carried out on the treated area, which disinfects this area as much as possible;
- two vertical and one horizontal incisions are made on soft tissues, which makes it possible to open the flap - it is supposed to use a standard scalpel of the required size, but in modern clinics most often they use a laser;
- in an open area, the doctor performs actions that involve cleaning periodontal pockets, removing plaque and tartar from the tooth surface, eliminating infection (antiseptic treatment), if any;
- at the end, the flap closes back and stitches are placed on the gum.
If an increase in the volume of soft tissues is required, in addition, a specialist can sew another area taken from the sky. After that, the treated area should be treated with antiseptic agents to prevent infection from entering the open wound. After this, the patient is explained the rules of care after surgery for the oral cavity.
Gum repair can be performed in two versions:
- simultaneously with the implantation procedure;
- a certain period after the absolute healing of tissues and the integration of the rod into the bone.
In the second case, the surgical intervention takes place in a slightly different way - in addition to gum correction, the cap is removed from the implant and the shaper is installed, which makes the gingival margins correct and even.
The rehabilitation period after surgery
When will the gum repair after implantation?
How many days can I remove stitches? All this depends on the variety and volume of surgical manipulation performed, as well as the patient’s condition and the ability of his tissues to recover. Thus, after the operation according to Lukyanenko, complete healing is observed after about 10 days, and if a gum former was used, then this process can take up to 14 days.
It is important to follow the basic rules of care after surgery for the oral cavity.
With weakened immunity or improper care of the wound surface, the regeneration process may be delayed. In some cases, complications arise, therefore, for any negative symptoms and discomfort, you should immediately contact your dentist for an examination.
Doctors advice
The specialist must tell the patient in advance about how oral care should be carried out after gingivoplasty. The following activities are usually expected:
- The mechanical effects of brushing the teeth should be minimized, if not completely eliminated, since this process can disrupt the integrity of the joints and soft tissues.
- After meals, it is necessary to rinse the oral cavity thoroughly with special antiseptic fluids or a solution of iodized sea salt.
- Sweet, spicy, salty, smoked, hard, sour, cold and hot foods are excluded from the diet for a while.
- During the recovery period, smoking and drinking alcohol should be abandoned, since the substances that they contain have a devastating effect on the state of soft tissues, which will significantly complicate the healing process.
- Physical activity is limited.
- Thermal rest is very important - the gums can neither be supercooled, nor overheated.
- To prevent infection and inflammation of the gums, you should periodically rinse them with antibacterial and anti-inflammatory drugs, which will be prescribed by a specialist.
- If any pain occurs, pain medication is possible.
- To protect against mechanical damage, wearing a special soft dental mouth guard for teeth is recommended. They are special removable lining made of silicone or plastic, repeating the shape of the teeth. They are worn directly on the teeth and can be removed if necessary, for example, before hygiene procedures or eating. Dental mouthguard can be purchased at a pharmacy or specialty store.
- Usually, discomfort disappears on its own by the fifth day after surgery, swelling of the tissues subsides, and pain cider completely disappears. At this stage, the doctor removes the stitches and examines the healed surface.
Today, in modern dentistry, Osstem implants are most often used, the use of which minimizes the occurrence of complications after implantation. They are made by the Korean company Osstem, which developed this product back in 1992. Currently, Osstem implants are used in more than 40 countries around the world. All products pass quality control, which allows us to assign it a high class of quality and safety.
Gum repair result
In this case, you should pay attention to the choice of a professional dentist during the implantation procedure and subsequent gingivoplasty. Only in this way can we guarantee good results that will help to find the perfect smile and restore the functional state of the dentition.
Thanks to gum correction after implant placement, you can achieve high aesthetic indicators, hide the roots of natural teeth, and also protect damaged tissues from infection. All this contributes to the health of the oral cavity and good appearance.
Possible complications
Since surgical intervention, even if all safety principles are observed for the body, is always severe stress, it can result in negative consequences, which will have to be eliminated separately in the future:
- Temporary loosening is observed, however, if after a week it has not passed by itself, a series splinting is required. This is done using locking elements on the back of the tooth.
- Swelling from plastic after implant placement is considered the norm only if it decreases during the healing process. If it persists for more than five days, this indicates the development of a pathological process of inflammation.
- Pain is stopped with the help of special medications.
Reviews
In reviews of gum repair after implantation, it is indicated that such manipulation in most cases takes place with minimal risk of developing unpleasant consequences. Patients noted that after the surgical intervention, they had pain in the gums, discomfort, bleeding. Such symptoms normally went away within a few days.
In addition, in the reviews, patients indicate that a lot depends on the experience of the dentist who performs the plastic surgery. The professionalism of the doctor can be considered a guarantee of the success of the procedure and subsequent recovery.