Adjunctive Periodontal Procedures for Successful Orthodontic Treatment
Healthy, Beautiful Smile That's Good for Life
The goal of orthodontic treatment is to provide patients with a functional bite and a healthy, beautiful smile that’s good for life. Your orthodontist works with your dentist and other dental specialists, as necessary, to achieve this goal.
Sometimes orthodontic treatment alone is not enough to address all of the problems that exist in a patient’s mouth, so your orthodontist may enlist the aid of your dentist or dental specialists to provide additional treatment before, during or after orthodontic treatment.
If an adjunctive (additional) treatment is recommended by the orthodontist, you may be referred to your dentist or pediatric dentist, a periodontist, an oral and maxillofacial surgeon or a prosthodontist for the procedure.
This brochure will help you understand what some of these adjunctive periodontal procedures are and why they are necessary to create or maintain the desired result.
What is a frenectomy?
A frenectomy is a minor surgical procedure that removes or repositions a portion of the frenum when there is excessive or particularly thick tissue.
What is a frenum?
The term “frenum” refers to the fibrous gum tissue that connects the lips, cheeks or tongue to the gums.
Who needs a frenectomy and when?
A frenectomy is most often performed for patients who have a gap (diastema) between their upper two front teeth that may be caused by the frenum. The procedure repositions or removes some of the tissue to allow the diastema to close and stabilizes the teeth so the space can remain closed. Patients with a thick frenum may need the procedure to relieve tension that otherwise could eventually cause gums to recede. A frenectomy may be recommended to achieve optimal results from orthodontic treatment. The orthodontist is in the best position to advise if the procedure is indicated and, if so, when it should be performed.
What is a fiberotomy?
A fiberotomy is a minor surgical procedure that releases tiny elastic fibers around teeth. For some patients, these fibers cause teeth to turn, or rotate, significantly. The procedure may be recommended as an additional measure to maintain the functional bite and healthy, beautiful smile achieved through orthodontic treatment.
Who needs a fiberotomy and when?
Patients whose teeth had a high degree of rotation before orthodontic treatment may need a fiberotomy. Such teeth have a strong tendency to relapse, or return to their original positions, due to the “memory” of the elastic fibers. This “memory” may work to return the teeth to their pre-treatment positions. A fiberotomy releases the elastic fibers to minimize rotational relapse after braces or other orthodontic appliances are removed.
The orthodontist will base the recommendation for a fiberotomy on his/her education and clinical experience. Your orthodontist is in the best position to advise on the timing of this treatment.
Retainers may still be needed to maintain alignment of the teeth following treatment.
What is a gingivoplasty?
A gingivoplasty is an adjunctive, or additional, procedure that may be performed separate from, or often, at the same time, as a frenectomy or fiberotomy. A gingivoplasty can be a removal or sculpting of gingival (gum) tissue. It can be done to remove excess (hyperplastic) gum tissue, to correct a “gummy” smile, or to balance uneven gum heights.
Who needs a gingivoplasty and when?
Your orthodontist may recommend a gingivoplasty if there is hyperplastic tissue. This condition can be caused by poor oral hygiene, especially during orthodontic treatment; some medications; or some illnesses.
Some patients may opt for a gingivoplasty if they have a “gummy” smile. This kind of gingivoplasty is often referred to as “crown lengthening.” It uncovers normal tooth surfaces that are concealed by excess gum tissue, and contributes to a more beautiful smile.
Patients whose gums are uneven may be candidates for a gingivoplasty to sculpt and even out the height of the gums. The result is a balanced, symmetrical appearance of the teeth.
The orthodontist will advise when a gingivoplasty should be performed, whether during or immediately following orthodontic treatment.
How do I know this procedure is the right thing to do?
Your orthodontist has the education and experience necessary to diagnose problems that can affect orthodontic treatment.
Orthodontists receive an additional two to three years of specialized education beyond dental school to learn the proper way to align and straighten teeth.
Only those who have completed this formal education may call themselves “orthodontists”, and only orthodontists may be members of the American Association of Orthodontists.
Orthodontists limit their practices to orthodontic treatment.
Procedures that fall outside of their scope of practice are referred to an appropriate dental professional. A team approach to care, interdisciplinary treatment that includes the patient’s dentist and other dental specialists, may yield the best results.
We will be happy to arrange a Free Consultation for you in order to get all the information you need to know