A Comprehensive Examination of Surgical Approaches in Periodontal Treatment: An Updated Review

Abstract

Background: Periodontitis is a chronic inflammatory condition resulting from dysbiotic microflora in genetically predisposed individuals, affecting approximately 11% of the global adult population. This disease leads to progressive destruction of periodontal tissues, potentially resulting in tooth loss and impaired quality of life. Effective management requires early intervention, primarily through non-surgical therapies such as scaling and root planing. However, surgical approaches are essential for more advanced cases, particularly when non-surgical treatments prove insufficient.

Aim: This review aims to provide a comprehensive examination of various surgical approaches in the treatment of periodontal disease, including techniques for pocket reduction, bone regeneration, and mucogingival defect correction, while highlighting indications, contraindications, and advancements in periodontal surgery.

Methods: This updated review synthesizes the latest literature on periodontal surgery techniques, focusing on indications, procedural details, and outcomes. The review discusses surgical interventions for both pocket reduction and restorative purposes, including gingivectomy, gingival flap procedures, osseous surgery, bone grafting, and mucogingival surgeries. Additionally, the review explores factors that influence the selection of these procedures, such as the severity and location of bone defects, as well as patient health factors.

Results: The review highlights the effectiveness of periodontal surgical interventions in managing advanced periodontitis, emphasizing how they contribute to better long-term outcomes compared to non-surgical treatments. Surgical techniques like osseous surgery and regenerative therapy with bone grafts have shown significant improvements in both clinical attachment levels and overall periodontal health. The review also indicates that surgical intervention should be carefully considered in cases with residual deep pockets or significant bone loss, where non-surgical methods are less effective.

Conclusion: Surgical intervention in periodontal treatment plays a crucial role in managing severe periodontitis and correcting mucogingival defects. When indicated, these procedures significantly enhance periodontal regeneration and functional restoration, leading to improved patient outcomes. Proper patient selection and careful planning are essential to maximizing the benefits of periodontal surgery.