Figure 6-12. - Periodontal periosteal elevator.
Figure 6-13. - Periodontal knife.
to remove granulation, fibrous tissue, and hard-to-remove subgingival calculus deposits.
Because of bone loss accompanied in some cases of periodontal disease, it may be necessary for the periodontist to recontour the bone during periodontal surgery. In such cases, the dentist may use periodontal surgery chisels, hoes, and files. They are also larger and heavier than those used in scaling and root planing.
Electrosurgery equipment uses a high-frequency electric current to cut tissue. The electrode attachment used will depend on the extent of the tissue removal required. One advantage of using the electrosurgery is coagulation and the control of bleeding.
Treatment of periodontal disease and occlusal trauma may include several nonsurgical procedures, such as equilibration, periodontal scaling, scaling and root planing, and root desensitization. Gingival curettage, which is considered a periodontal surgery procedure, is commonly performed in conjunction with scaling and root planing.
Occlusal interferences and oral habits, such as bruxism and clenching, can cause the mandible to shift out of its normal position when the maxillary and mandibular teeth occlude. This chronic shifting of the mandible during oral functions is traumatic to the joint, and may cause muscle spasms, and hypersensitivity and hypermobility of teeth. The elimination of occlusal interferences and establishment of favorable occlusal forces on the teeth is called occlusal equilibration.
The two types (limited or complete) are discussed below.
Limited occulusal adjustment involves reshaping the occlusal or incisal surfaces of the teeth by grinding to improve inter-arch tooth contact relationships. This type of adjustment is limited to one or more selective teeth being reshaped.
Complete occlusal adjustment involves reshaping the occlusal and or incisal surfaces by grinding to achieve correct contact during functional movement (grinding side- to-side and sliding the jaw forward). A complete adjustment involves all or nearly all of the teeth. 6-9