Differences between flap surgery and curettage. Gum curettage - purpose, methods of implementation, reviews and prices. Innovative methods of conducting

Sometimes it is not enough to treat gum disease drug treatment. Most common cause Inflammatory processes are caused by contamination of the periodontal pocket with food debris. During normal tooth brushing, this area remains inaccessible, so it can cause the development of serious illnesses. Treatment in this case is based on cleaning out the cavity between the tooth itself and the gum. This procedure is called curettage.

In order to understand what curettage is, you need to roughly understand where exactly the problem is. Teeth are bony outgrowths that are nourished by blood vessels and nerve endings. The root canal goes deep into the gum, which covers most of the tooth, leaving only the coronal part necessary to perform its functionality. However, the gum itself does not fuse with the tooth, creating a hollow area between the tooth and the soft tissue. The greatest separation between the tooth and the gum is located near the crown part, so food debris often gets into this gap, but it is not possible to remove them from there yourself.

Curettage – dental procedure, in which, using special means, the cavity is cleaned, which is also called a periodontal pocket. This procedure relieves gum inflammation and eliminates other soft tissue problems. oral cavity. To carry out the procedure, ultrasonic cleaning agents or surgical instruments. The choice of curettage products depends on how deep the separation needs to be cleaned. A similar procedure can also be carried out in diagnostic purposes to understand the condition root canal, hidden by the gum.

Types of curettage

There are 2 types of curettage:

Open;
Closed.

There are quite a lot of differences between the two types of procedures, since open curettage is a full-fledged operation, while the closed method uses less traumatic methods of “entering” the periodontal pocket, although in both cases anesthesia is used in order to avoid unpleasant and painful sensations during procedure time.

Closed curettage is performed after professional teeth cleaning. This sequence allows you to maximally avoid additional contamination of the sinuses during the procedure. This procedure, despite a rather harmless and even beneficial interaction, is carried out only as prescribed by a dentist after the cause of gum disease has been identified. Either special instruments are inserted into the periodontal pocket to help manually clean the sinus, or ultrasonic cleaning, as a more effective and simpler method.

The open type of curettage involves cutting the gums, which is why the operation is often called patchwork. This method is used for deep periodontal pockets, since conventional instruments are not designed for a depth of more than 5-6 mm. When the gums are cut, the doctor gets a complete picture of the condition of the tooth root, as well as the adjacent soft tissues. During the operation, not only the formations are removed, but also the application of strengthening drugs to the tooth enamel. As a rule, a bone-forming ointment is used, which promotes the fusion of the gum and tooth root, and also strengthens the root itself. After the cleaning procedure, the gums are closed and sutured.

Curettage of periodontal pockets and teeth

Curettage is not always carried out to remove formations in the cervical part of the tooth. Sometimes in this way they diagnose the condition of the root or treat a tooth with preliminary cleansing of the sinus. As therapeutic measures When curettage of teeth, polishing of the enamel is used, as well as applying medicines. Typically, such manipulations are performed with open curettage.

In all cases, after the procedure, the affected periodontal pocket expands, so the first time after the procedure may be accompanied by painful sensations in the oral cavity. However, despite the increase in large pockets, the small ones close completely, and after some time soft fabrics The gums begin to move closer to the tooth, closing large sinuses with a minimum gap.

Indications for curettage

The main indication for curettage is gum disease, the most common of which is periodontitis or gingivitis. After diagnosing the disease, the dentist determines what type of curettage will help solve the problem. Closed curettage with ultrasound is prescribed when the disease is not too serious, when the depth of the dissection is about 4 mm. Gums with such a depression are quite dense, so there are no additional complications during the procedure. You also need to make sure there are no bony pockets, as these will prevent the sinuses from clearing.

Flap surgery is performed in virtually all other cases of periodontitis, when the gum itself begins to loosen. In such situations, the teeth are extremely mobile due to poor attachment to the gum, because the width of the pocket is 5 mm. Also, periodontitis begins to appear externally in the form of abundant tartar, as well as deformation of the interdental papillae. Also an indication for curettage open view There may be complications in tooth treatment, in particular the need to strengthen the root with a special bone-forming compound.

Gum curettage

Gum curettage is medical procedure, which is often compared to professional teeth cleaning.

The main goal of both procedures is to remove deposits, in particular tartar, which spreads along the enamel not only on the coronal part visible to the naked eye. Some of the deposits are located close to the gums and are difficult to remove with daily hygiene. This condition may also be an indication for a curettage procedure.

Together with tartar during gum curettage, antiseptic treatment oral cavity, as well as periodontal pockets, which allows you to kill bacteria that multiply in the cavity between the tooth and gum. The waste products of such organisms are destructive substances that negatively affect both the condition of tooth enamel and the condition of the hard part of the gums. A striking example is gingitis, the symptom of which is gum porosity.

Socket curettage

The curettage procedure is performed not only around the entire tooth or filling. Very often the area after tooth extraction needs such cleaning. Such a hole is the most vulnerable place for bacteria, especially if the tooth extraction was unplanned. A hole occurs in cases of natural tooth decay in people who, for some reason, could not consult a dentist about the problem in time. Most of tooth is removed naturally, but fragments remain in the hole, which scratch soft tissues and often cause irritation, swelling or inflammation.

Curettage of the hole involves several stages of the procedure, the main of which is the cleansing of part of the gum from large tooth fragments and the remains of a destroyed filling. When the main debris has been removed, the dentist proceeds to treat the gums, including cutting out some of the damaged tissue and cleaning the areas of inflammation from accumulated pus or bacteria. Lastly, the patient’s operated area is disinfected with antiseptics. However, to avoid infections and re-inflammation of the gums, it is necessary to adhere to the recommendations during the recovery period.

Rehabilitation period after curettage

The curettage procedure is not only painful, but also quite painful in the subsequent period. Immediately after the procedure, the oral cavity is especially vulnerable to infection. In addition, the problem of gum swelling and tooth pain does not go away within a few days. Patients who have undergone periodontal pocket curettage must adhere to several rules:

Refusal of solid food. The first few days your gums will be very sore, so in order not to injure them with stress, you need to switch to a liquid diet.
Refusal to brush your teeth. After the procedure, the dentist will tell you exactly how long you should abandon any type of oral hygiene, including rinsing, since even mild Toothbrush applies mechanical damage gums, and rinses can cause long-term non-healing in the postoperative period.
Mouth rinses. After 3-5 days, the gums will begin to heal, this will help speed up the process home care, in particular, rinsing the mouth with antiseptics and other medications.
Mandatory visit to the dentist. Depending on the speed of healing, further recommendations for caring for the oral cavity in the postoperative period depend, so the dentist will schedule a session to check the condition of the gums; skipping an appointment with the doctor is not recommended.

Contraindications

The procedure has practically no contraindications, since most of them are temporary. You should not undergo the procedure for acute common diseases, as well as in acute period inflammation of the gums, since operations during this period are very traumatic. Inflammatory process at such moments it is expressed in swelling, change in the color of the gums, as well as the release of pus from the periodontal canals.

Constant contraindications include excessive looseness of teeth (above the third degree of mobility), which indicates pathology fibrous tissue who does not want to hold her teeth. Also, the procedure is not performed if bone pockets are identified.

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Curettage of periodontal pockets is deep cleaning pathological gingival depressions in the root zone of the teeth.

In dentistry “All yours!” 2 methods of cleaning pathological areas are used - closed and open. Closed curettage is performed with pocket depths up to 5 mm: the roots of the teeth are cleaned of subgingival deposits without surgical dissection of the gums.

The open method is practiced for deeper periodontal pockets (from 5 mm): the gums are peeled off, granulations are removed and the roots of the teeth are polished. Then stitches and a protective bandage are applied in the intervention area. The procedure is not pleasant, but thanks to effective anesthesia and the experience of periodontal surgeons at our clinic, it is absolutely painless for the patient.

In “All Yours!” You have the opportunity to undergo both manual and laser curettage of periodontal pockets - using a dental curette or diode laser. Curettage is performed using sterile instruments, in compliance with the standards of the Anti-AIDS program. And the price for the service is one of the most affordable in Moscow.

Timing of curettage

Closed curettage lasts 30-40 minutes, open - 1-2 hours, depending on the number and size of periodontal pockets.

Their depth is determined using a dental probe. For generalized periodontitis and visible atrophy of the jaw bone, radiography is used for diagnosis.

Complete healing of periodontal tissue occurs 3-4 weeks after the procedure. Removal of sutures when using open cleaning of the roots of the teeth is carried out after 5-7 days.

Why is curettage of gum pockets performed?

Properly performed closed curettage allows you to eliminate periodontal pockets, restore atrophied bone tissue, and prevent gum recession and loosening of teeth.

During the procedure, the roots of the teeth are cleaned of granulations and microbial plaque - subgingival deposits, polished and treated antibacterial drugs what serves effective prevention periodontitis.

When destroyed normal structure of the alveolar process of the jaw in the intervention area, a synthetic graft is made bone tissue.

Absence timely treatment leads to deepening of gum pockets and pathological mobility of teeth, which is an indication for their removal.

Gum inflammation and curettage

The main cause of gum inflammation is soft microbial plaque and hard deposits (stone) in the root zone of the teeth. These factors contribute to the formation of periodontal pockets with bone resorption, periodontitis and systemic gum damage, periodontal disease. Curettage - radical, but 100% effective technique treatment of periodontitis, periodontal disease and gum injuries.

Sign up for open, closed or bloodless laser cleaning of periodontal pockets at the “All Yours!” dentistry nearest you. in Moscow!

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Anonymous:

I suffered from periodontal disease for several years and periodically underwent treatment/prevention procedures. I came to see Elena Sergeevna Solomatina and she advised me to do closed curettage. I agreed, even though I knew it would be very painful. They administered anesthesia, everything was numbed, but it took a very long time to recover from the procedure. The effect is noticeable.

About dentistry at: m. Belyaevo, st. Profsoyuznaya, building 104/d

Solve the problem without surgical intervention during complex treatment, it is usually not possible. Curettage allows you to remove the pocket between the tooth and gum. The procedure involves: removal of tartar, scraping of granulations from the walls of the gums and the bottom of the formed cavity, tissue treatment antiseptic drugs, application of protective bandages.

Indications

There are a number of indications that require periodontal pocket curettage:

inflammation of the gums;
the formation of cavities between the tooth wall and gums;
the occurrence of abundant deposits of tartar;

Curettage of gum pockets should not be considered as an alternative to professional enamel cleaning. In the latter case, only removing plaque and polishing surfaces is carried out. Complex treatment pockets in the gums not only allows you to get rid of deposits, but also eliminate the flow pathological processes in tissues and avoid their breakdown.

Contraindications

Treatment of periodontal pockets using curettage is contraindicated in purulent discharge, suspicion of tissue abscess, presence of pockets in bone structure, expansion of periodontal cavities to a depth of more than 5 mm. It is prohibited to carry out the procedure in case of extreme thinning of the gums, their fibrous changes, or grade 3 tooth mobility.

Curettage of periodontal pockets - types

There are several types of procedure:

Open curettage – required when opening pockets to a depth of 4 to 5 mm. During the event, the affected area is affected, which makes it possible to gain open access to the preparation of the tooth roots and perform deep cleaning fabrics.
Closed curettage of periodontal pockets is performed when the depth of the canals is insignificant. The procedure does not require cutting the gums.
Patchwork gum - not only pockets are cleaned, but also deep surfaces and tooth roots. Can be used to restore tooth structure artificial materials, which stimulate the growth of new tissue.

Flap surgery on gums

Open curettage

The operation is relevant when the depth of the pathologies is more than 5 mm. In addition, the method is used if closed treatment of gum pockets does not bring results.

A prerequisite for this is surgical dissection of the affected gum. Open curettage of periodontal pockets is carried out in several successive stages:

The condition of the gums is diagnosed.
Local anesthesia is performed.
The gums are dissected in the area of the interdental papillae, which facilitates access to the base of the pockets.
The fabric is cleaned using specialized tools.
For the purpose of restoration, the bone pocket is treated with osteogenic stimulating drugs.
At the end of the operation, the gums are sutured.

It is carried out if the pocket in the gum between the teeth has a depth of up to 5 mm. The operation is performed without surgery and consists of the following measures:

General diagnostics of tissue condition.
Local anesthesia.
Using a special tool, the periodontal pocket is cleaned without disturbing the structure of the gums.
The tissues of the tooth roots are polished.

The closed method allows you to reduce deep periodontal pockets and completely eliminate small ones. The operation causes less discomfort for the patient compared to the open method of preparation. Therefore, closed curettage looks preferable if it is possible to carry it out.

Closed

Flap surgery

The method involves cutting out the periosteal surface of the gums, followed by treatment of the root and internal soft tissue. Flap surgery for periodontitis provides good visual control, which facilitates convenient removal of pathological material.

During the recovery phase, a number of complications may occur. First of all, this is an increase in the likelihood of exposing the necks of teeth, a change in alveolar processes, dentin hypertension and aesthetic defects outer fabrics.

Features of flap surgery and its consequences

Periodontal treatment using this method involves sanitizing the oral cavity, local anesthesia and the use of antiseptics. Further to the transitional fold, starting from the edge of the gum, several vertical incisions are made. Two more incisions are created on the vestibular and oral sides with an indentation of 2.5 mm. The cut off parts of the tissue are removed. In order to preserve the natural material, one horizontal section is allowed, similar to an open curettage.

The prepared gum is peeled off, the periosteal flap is folded back to the transitional fold - the mobile area of the mucous membrane. Pathological root cement is removed. The gum pockets are cleaned. The dental roots are polished with periodontal burs and rasps.

Cleaning pockets

Upon completion of the treatment of hard surfaces, soft tissues are prepared. Subsequently, the ingrown epithelium is removed and the granulation tissues are truncated. Alveolar osteoporotic processes are treated, surgical wound washed with antiseptic solutions.

If dissection of the gums reveals bone defects, the anatomical structure of the tissue is restored using artificial graft material. The flaps are placed in place, after which surgical sutures are applied. Finally, the prepared tooth is covered with a protective bandage.

For several weeks after the operation, tooth mobility is noted. Then the effect gradually disappears. Additionally, increased tissue sensitivity to temperature and chemical stimuli may be felt. Discomfort may persist for a month.

As practice shows, brushing your teeth with a desensitizing paste helps eliminate discomfort after surgery. The consequences of the procedure may include bruising and swelling, which disappear naturally after 2 weeks.

Closed and open curettage does not allow you to open your mouth wide at first. The functions of the jaw muscles are restored within 5-10 days.

Postoperative period

To avoid opening the prepared periodontal pockets, you should avoid eating and drinking after surgery. During the first 10 hours, it is forbidden to brush your teeth, rinse your mouth, or actively spit saliva.

In order for gum surgery to give the expected result, you need to carefully brush your teeth using a brush with soft bristles. Cleaning the oral cavity should be done by bypassing the problem area.

Prepared gum pockets must be periodically rinsed with salted water or chlorhexidine solution. It is acceptable to apply cold compresses to outside postoperative area during the first hours after the procedure.

Salted water

At first, liquid, pureed and soft food is taken. The consumption of cold and hot drinks is prohibited. For a week after curettage of the periodontal canals has been performed, you should refuse physical activity, contact sports, visiting the sauna.

IN postoperative period it is necessary to resort to using special means for oral care for sensitive teeth. Additionally, you can contact your dentist to carry out a number of measures that will reduce the sensitivity of the necks of your teeth.

Quality criteria

Cleaning the cavities from granulation material stops the processes of damage resorption. The use of restorative bone-forming substances stimulates the growth of missing tissue. In general, the operation should close the dental pocket, relieve tissue inflammation, and remove hard deposits.

Price

The price of curettage is on average from 200 to 500 rubles for the procedure using the closed method and from 300 to 1000 rubles for the open method of preparation. The stated range varies slightly depending on several factors.

Technical capabilities, level of equipment, availability of materials, and quality of anesthesia come first. Equally important human factor– characteristics and nature of the disease in a particular patient. The cost of service is influenced by the class and experience of the specialist, the status of the clinic, and reviews of curettage from regular clients.

More expensive is laser curettage of periodontal pockets, which does not use traditional surgical instruments, and the procedure is performed quickly and painlessly.

Laser

It is better to perform a procedure so important for health and future well-being by contacting a dentist with a good reputation, regardless of the financial implications.

Finally

As can be seen, despite different approaches to performing an operation and methods of gaining access to the area of development of pathological processes, eliminating a pocket in the gum allows methods that have general features. The described methods are aimed primarily at removing granulations, dental and subgingival deposits, ingrown oral epithelium, and cement of an infected tooth root. In other words, in all cases the formed pocket is eliminated, the same tissues are truncated, but using different approaches.

Have you missed a couple of routine dental checkups and missed your gum disease? It can happen to anyone, because at first periodontitis is asymptomatic. When the gums become swollen, begin to hurt and bleed, bad smell the mouth and teeth turn yellow from plaque - everyone runs to the doctor.

At such stages of gum inflammation, curettage of periodontal pockets is indicated - mechanical removal of subgingival deposits. Conducted open and in closed ways. Read more about each in our article.

Description of the procedure

Curettage of a periodontal pocket is carried out using a special instrument - a dental curette (another name is a curettage tray).

A curette is inserted into the gum pocket and all plaque accumulated in the pocket is scraped out. The procedure is painful, so it is performed under local anesthesia.

In case of advanced periodontitis, granulation tissues are also removed. They replace atrophied bone tissue, which has dissolved under the influence of toxins secreted by bacteria “living” in the pocket.

It is worth noting that scraping subgingival deposits does not replace full-fledged professional teeth cleaning. This is just one stage of it, along with removing tartar and soft plaque from the enamel, as well as polishing the surface of the teeth.

When to curettage gum pockets

The most important indication is inflammation of the gums, in which periodontal pockets more than 3 mm deep are formed. This means that the gums “lag behind” the tooth, and as a result, a cavity is formed between them, into which microbes penetrate.

This can happen against the background of the following diseases:

periodontitis;
periodontal disease;
gum injuries.

Contraindications

The presence of periodontal abscess (purulent tumor);
copious discharge pus from gum pockets;
thinning gums;
gum fibromatosis;
pathological mobility of teeth III-IV degrees;
spicy infectious diseases oral mucosa;
others spicy infectious diseases(sore throat, flu, etc.);
general contraindications to surgical procedures.

Methods of conducting

Vacuum curettage

Closed curettage, which uses vacuum apparatus, instantly removing the scraped plaque from the pocket.

Laser curettage

Instead of a curette, a laser device is used, under the influence of which the plaque evaporates.

Cryo-curettage

A special cryo-probe destroys plaque with ultra-low temperatures.

Chemical curettage

Before removing plaque, it is softened with lactic or citric acid.

Most dental clinics use closed and open methods - they are considered traditional when removing subgingival deposits.

The technique is justified if the depth of periodontal pockets does not exceed 5 mm - at the mildest stages of periodontitis. Its peculiarity is that the doctor performs the procedure virtually blindly, since there is no opportunity to look under the gums. At the same time, delicacy is very important; if you work carelessly, you can damage healthy gum tissue and scratch the surface of the tooth.

This surgical procedure carried out in cases where the depth of the gum pockets is more than 5 mm. Using a scalpel, the surgeon makes incisions in the gum and peels off a flap of its mucous membrane from the teeth.

The exposed roots are thoroughly cleaned of plaque and granulation tissue and then polished. The area is being processed antiseptics, after which an osteogenic preparation is placed into the periodontal pockets, stimulating the restoration of bone tissue.

Then the gum flap is returned to its place, sutures are applied in the area of the interdental papillae, then a protective gum bandage is applied. The sutures are removed ten days after the operation.

After the procedure you cannot:

stop caring for the oral cavity (germs can enter tissues weakened after surgery and cause inflammation);
touch the area of the gum where the procedure was performed with the brush;
eat solid food for the first two to three days;
spit.

avoid hot food and drinks until healing;
use antiseptics - wipe your teeth with solutions of Chlorhexidine, Miramistin, rinse your mouth with these and similar drugs after meals;
if necessary, apply cold, which will help relieve inflammation after surgical procedures;
drink only through a straw in the first hours after open curettage, so as not to cause bleeding.

What is the price

average price closed curettage– 100-200 rubles for cleaning a gum pocket in the area of one tooth.
Open - in the area of one tooth costs from 2,000 rubles, for a quadrant (six to seven teeth) - from 9,000 rubles.

Pros and cons

Benefits of the procedure:

the possibility of eliminating pathological gum pockets. Open curettage is the only method that allows you to achieve this result);
restoration of bone tissue due to the implantation of osteopreparations using an open technique;
getting rid of pathological tooth mobility. When bone tissue is restored, teeth are held stronger;
low cost of closed curettage.

There are also many disadvantages. First of all, the low effectiveness of closed curettage for moderate and severe periodontitis (in 99.98% of cases the disease recurs) and the high cost open method(in addition to the doctor’s work, the total amount includes suture material, osteogenic drugs).

duration of the open curettage procedure.

Approximately 2 hours to work in the area of 6-7 teeth;

high requirements for the qualifications of a doctor.

Otherwise, there may be injuries to the mucous membranes and damage to the teeth.

Open curettage of periodontal pockets should be performed exclusively by surgeons specializing in periodontology. On our website you can find clinics that successfully treat periodontitis using a similar technique.

Any gum disease is a very long and unpleasant process. Increasingly in dental clinics patients come with problems similar to gingivitis, or a more complex form inflammatory disease– periodontitis.

Although these types of diseases seem harmless at the beginning, they can lead to serious problems, up to the loss of teeth.

That is why in dental practice one of the most effective methods Treatment of gum disease is curettage of periodontal pockets. About what methods modern technology uses to carry out this procedure surgical dentistry, and how they differ will be discussed in this article.

general information

Treatment of periodontitis involves a whole range of procedures aimed at eliminating the cause and the possibility of reoccurrence. If the disease is mild or moderate severity, then curettage will be part of this complex.

At its core curettage is the cleaning of periodontal pockets that form between the gum and tooth. Sometimes it is called differently - dental, periodontal, gingival pocket.

If its dimensions exceed 3 mm, then cleaning using conventional methods is ineffective. Therefore, surgical ones are used.

Formation of periodontal pockets

In order to understand this, you need to know general information about the course of periodontitis.

One of the factors in its development is poor hygiene oral cavity, which allows the formation a large number deposits of various kinds on the surface of the tooth.
Inflammation in the gums is triggered by microorganisms contained in plaque.
Mineralization of plaque leads to the formation of extremely hard deposits, which are called tartar, and it, in turn, tightly attached to the enamel, produces pathogens and toxins as a process of their vital activity.
The onset of inflammation provokes changes in bone tissue – its atrophy and resorption.
Granulation tissue that appears at the site of resorption further accelerates the process of bone destruction.
A cavity gradually forms in place of the destroyed bone tissue. There is no normal attachment of the gums to the teeth and there is a lot of deposits and granules.

The need for

The need for this operation is explained, first of all, by the fact that the process of atrophy, destruction and replacement of healthy tissue with granulate becomes almost irreversible when gum pockets form.

Anti-inflammatory and local therapy, together with superficial cleaning and taking antibiotics, have only a short-term effect.

First of all, by acting conventional methods, the doctor is not able to completely clean the cavity, since he acts almost blindly. Granules and bacteria that remain inside provoke further development diseases.
In addition, even if it is possible to clean all the deposits, the periodontal pocket will not go away. It is here that there are ideal conditions for the resumption of infection and the progression of the disease.

Therefore, a method is needed, which is curettage, which allows you to immediately eliminate the entire list of problems:

Deposits on the surface of the tooth and those hidden by the gum.
Granulation tissue formed as a bone substitute.
Periodontal pockets.

There are several surgical techniques that serve the same purpose. It is the elimination of altered and diseased tissues to eliminate pathogenic factors. They differ from each other only in the degree of intervention and the method of performing the operation.

Closed operation

If the patient is found easy stage periodontitis, when the depth of the pockets is small - about 3-4 mm, then the first type of closed curettage is often used.

Its purpose is to remove granules, deposits located under the gum, affected dental root cement, decomposed tissue and particles.

The main feature of the technique is that the manipulations are carried out by the dentist blindly, without excision of the gums and full access to the affected cavity. The lack of visualization requires the surgeon to be extremely meticulous, have great patience and professional skills. After all, in addition to removing altered diseased tissues, healthy ones cannot be damaged.

Indications

Necessary for mild to moderate types of the underlying disease. In this case, the depth of the cavity should not be more than 4 mm, otherwise there will be no expected effectiveness. The presence of so-called bone pockets is also unacceptable, and the gum tissue itself must be of normal density.

Contraindications

Like all surgical procedures, closed curettage also has contraindications.

The pocket depth is more than 4.5 mm.
The presence of an abscess or suspicion of its presence.
The appearance of bone pockets.
Purulent discharge from the cavity.
Thinning or fibrotic changes in the gum tissue.
3rd degree of tooth mobility.
Certain infectious diseases of the oral cavity.
Some common diseases.

Methodology

There are several mandatory stages of the operation, the sequence of which must be followed.

The effectiveness of the operation can only be judged after sufficient time has passed for the formation of scar-connective tissue. This usually takes about 2-3 weeks.

The disadvantage of this technique is that without filigree precision, which only experienced professionals possess, healthy tissue can be damaged. This sometimes leads to complications in the form of pulpitis, prolonged bleeding, and suppuration.

Vacuum curettage

One of the types of surgery. Here the curettes are connected to the apparatus to create a vacuum. The main advantage of the technique is that pathological tissues are not simply scraped off, but are immediately removed from the cavity. This helps to significantly reduce the occurrence of all kinds of complications.

How to perform closed curettage of periodontal pockets - see the following video:

Open operation

The purpose of the operation is the same as in the case of closed curettage. But, unlike him, here the periodontal pocket itself is also removed, as a probable source of bacteria and a factor of possible relapse.

Indications

The depth of the pocket cavity is more than 5 mm.
Severe proliferation of granulation tissue.
Changes in the shape of interdental papillae.
Detachment of the gum edge from the surface of the teeth.

Contraindications

Possible necrotic processes in the gum tissue.
It's thinning too much.
Abscess.
The appearance of pus in the surrounding tissues and the cavity itself.
Various infectious dental diseases.

Methodology

As in the closed method, there are certain stages of the operation.

Treatment of the entire oral cavity with antiseptics, pain relief.
Making an incision along the tops of the interdental gingival papillae.
Peeling of the internal and external parts of the gums, as well as the mucous flap to a sufficient depth (no more than the depth of the formed cavity).
Complete removal of all deposits and diseased tissues with visual supervision by a physician. The tools used at this stage are scalers, hoes, curettes.
Polishing of all surfaces of the tooth and its roots.
Excision of altered and diseased periodontal tissues.
Removal of granulate and epithelium that has grown into the pocket.
Antiseptic treatment. Laying the papillae with their subsequent fixation surgical suture. Applying a protective bandage with anti-inflammatory drugs.

How to perform open curettage of periodontal pockets - see the following video:

Prices

The cost of both methods will be different and this does not depend on the clinic. The fact is that open curettage is not only the most effective for complex forms of the disease, but also requires great effort from the doctor.

The average cost of a closed type operation for one tooth is about 800–1000 rubles, and an open type operation is about one and a half to two times higher - up to 1,700 rubles.

This amount includes anesthesia, treatment with all kinds of drugs, and the work itself. Depending on the complexity of the operation, the price may be higher, but without an examination, the doctor is unlikely to be able to give the exact cost.

Also, prices may vary slightly depending on the region and clinic. Popular big dental centers that have a name and invite only experienced specialists can charge 30–40% more for the same operations.

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