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Periodontal preparation of the adult patient prior to orthodontics.

Evaluation of periodontal status and proposed orthodontic therapy must be made prior to initiating tooth movement. Teeth with a compromised periodontium can be treated. Prior to initiation of orthodontic therapy, it may be necessary to perform periodontal surgery for pocket elimination or reduction, to perform mucogingival surgery, or to correct gross occlusal discrepancies.

Adult↗

Preprosthetic surgery.

Several of the abnormal conditions existing in the edentulous patient can be corrected surgically, prior to construction of dentures, to enable the patient to function more successfully following prosthetic restoration. The more common problems have been discussed which often require surgical correction. In some instances, articulated diagnostic models of the patient's mouth show that surgery can be avoided, or when surgery is necessary, these models help identify the exact locations of the tissue to be corrected. Alveolectomy has been presented with an eye toward conservatism since this procedure affects the quality of denture foundation and therefore denture stability. Alveolectomy should be performed only when there is a definite indication for the procedure. Correction of soft tissue abnormalities can substantially improve the patient's ability to function with dentures and solve many of the adjustment problems which confront the dentist. It is often better to correct the soft tissue abnormality rather than to circumvent the problem with an inferior prosthetic restoration. Since the introduction of resilient acrylics and tissue conditioning materials, the patient need no longer suffer the discomfort of denture withdrawal after surgery. Electrosurgery has emerged as a successful method of correcting many soft tissue abnormalities. Vestibuloplasty is receiving much emphasis as a possible treatment for atrophic ridges in which there is still enough alveolar bone from which to extend a sulcus. These sulcus extension procedures may offer some help in the future regarding the problem of resorbed ridges, but presently, more research is necessary before widespread use is recommended.

Alveoloplasty↗

[Frena].

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Adult↗

[Oral frenula].

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Diastema↗

Regenerative and reconstructive periodontal plastic surgery. Mucogingival surgery.

Mucogingival surgery currently encompasses surgical management of many defects thought to be untreatable when the term mucogingival surgery was introduced in the 1950s. Mucogingival surgery has now expanded beyond the treatment of recession and problems associated with attached gingiva. Additionally, it would now include correction of ridge form, exposing unerupted teeth for orthodontic treatment, crown lengthening for esthetic purposes, and frenal surgery. With this in mind, mucogingival surgery has been redefined as "periodontal plastic surgery."

Gingiva↗