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Dental Disease And Ridge Augmentation

By Laura Minsk, DMD

Whether a tooth has been lost to periodontal disease, tooth decay, or trauma, one may be left with a cleft, an indentation, or uneven gum margins. This happens because after a tooth is removed, the bone that was encasing it disintegrates and the gum around it collapses. If this occurs in the front of the mouth, it can result in an esthetic problem. No matter how well designed the replacement teeth are, they may appear to be too long and unattractive. To have a pleasing smile, the shape, color, and texture of the gums is just as important as that of the teeth they frame.

Ridge augmentation is a cosmetic periodontal procedure that may include gum and/or bone grafting. A dentist will determine which option is better suited to a patient's esthetic needs. Regardless of what treatment method a dentist chooses, ridge augmentation is a very predictable procedure with long-lasting results.

What to Expect from Periodontal Ridge Augmentation

Ridge augmentation is a surgical procedure that is done in the dentist's office with local anesthesia (lidocaine). Stitches (sutures) are placed to aid in healing. Post-surgical discomfort can last a few days and is usually minimal. It can be easily managed with commonly available over-the-counter medications such as aspirin, acetaminophen, or ibuprofen. Patients can expect to follow their normal routine the day after oral surgery. The dentist will provide special instructions related to diet, exercise and medications.

To ensure more esthetic results, ridge augmentation procedures should always be done before new crowns are made. Although a temporary (provisional) tooth replacement can be made at the time of tooth loss, the final restoration should not be fabricated until after six to eight weeks of gum healing.

Alternatives periodontal treatments

It is possible to help prevent collapse of the gum tissue by doing a bone grafting procedure or by placing an implant at the time of extraction. Although sometimes it may still be necessary to do further periodontal plastic surgery procedures, these treatments can help maintain the space that was previously occupied by the tooth and prevent bone loss. If this was not feasible, ridge augmentation can be done to improve esthetics after tooth extraction.

Ridge augmentation should be considered as part of an individual's cosmetic dentistry options when there are uneven gum contours, clefts, or indentations on the gums. The most beautiful teeth will not look natural if the gum surrounding them is not cosmetically pleasing. Talk to a dentist about esthetic concerns and the possibility of incorporating cosmetic periodontal procedures (see article "Cosmetic Periodontal Procedures") as part of a "smile lift."

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