Category Archives: Services Minor surgery


Microimplants are small temporary fixings that are placed anchored in the bone for use during orthodontic treatment. They are like a small “pin” placed on the gum on which we can rest to make different movements in the teeth. Once the orthodontic treatment is finished, they are removed with local anesthesia in a simple procedure.

Dr. Akash use this auxiliary technique to achieve the best results in their orthodontic cases. Without this tool, many complex cases could not be addressed.

Why are microimplants used in orthodontics?

In orthodontics we apply forces to move the teeth. Every force applied in one direction will have a reaction of the same magnitude to the opposite side.

If we want to move the teeth of the anterior sector backwards, we have to rest on the back teeth so that the movement can occur and this force will produce a forward movement of the posterior sectors.

If our treatment goal is to retract the anterior front only (because the patient’s teeth are excessively placed outward) we do not want any undesirable movement of the posterior teeth.

By placing the microimplants a maximum anchorage is achieved (since they are temporarily fixed to the bone). In this way the upper incisors can be retracted back to the fixed target.

 What are the advantages of the microtornillos?

  • Thanks to its use, much more complex movements can be made that would be impossible only with the appliance.
  • Some cases that could only be treated with orthodontics and surgery can be solved orthodontically thanks to the microscrews.
  • It is a simple and painless procedure for the patient.
  • It opens a lot the range of movements that can be made and cases that can be performed with orthodontics.

How are the microtornillos placed?

They are placed in a very simple and short intervention, in which Dr.Ferrús uses local anesthesia in the area. There are mini orthodontic implants of different lengths depending on where they are going to be placed. 
It is not necessary to give stitches, just an ibuprofen when finished. The patient will notice a small button protruding from the gum. This button will remain in that position for a few months until it fulfills its function and then it will be removed very easily. The intervention does not last more than 5 minutes.

Will the surgery hurt me or the days after I put them on?

No. It is a very small surgery on the gum that does not bother anything. You can make normal life and there will be no inflammation of the area or pain. Sometimes the first day you have to take an ibuprofen if you notice some sensation in the area where it has been placed.

Can you see the microscrews?

No. The microtornillos are placed in the gum usually in the most posterior areas of the mouth (molars) and at a height above the smile arch so they will not see or talk or smile.

Once they have been placed how they are used?

On the same day of the intervention, an elastic band or chain that hugs the microtornillo and will be attached to the orthodontic device worn by the patient can be placed. (Whether lingual brackets , transparent sapphire brackets or metal brackets ). In each monthly appointment this elastic module will be changed, which is attached to the microtornillo to reactivate the force and move the teeth.

How long will I have to carry them in my mouth and how many?

The planning of the use of the dental micro implants is done at the beginning of the treatment after carrying out the detailed study of the case. That is why each case is different and its use is totally individualized.

In general they are usually used from 2 to 4 microtornillos of average that are placed in the later zones but it depends on each concrete case. If they are used to straighten the molars, only one is placed adjacent to the molar that we want to straighten. The average time of use is usually from 8 to 12 months.

Thanks to the use of microtornillos we can …

  • Perform the distraction of the upper molars to correct the bite.
  • They allow mass retraction of the vestibulized upper incisors.
  • They help us to make the straightening of the molars lying down.
  • They facilitate the realization of the posterior dental intrusion for the correction of the open bite.
  • Being an absolute anchorage (do not move) facilitate movements by shortening the treatment time and achieving better movement results.

The microtornillos are a fundamental tool for the achievement of the objectives in orthodontics and thus be able to achieve the best results in each case.

At the Ferrus&Bratos Clinic we have the latest technologies and techniques to achieve excellence in treatments.


An endodontics is performed when the nerve of the tooth is affected, either by causes such as caries where the bacteria have come into contact with the dental pulp (the nerve of the tooth) after having damaged the enamel (outermost layer of the tooth) and dentin (intermediate layer between enamel and dental pulp); or for any trauma that tooth has received and the nerve has been damaged. If with the treatment of the ducts, that is to say performing the endodontics,  it is not possible to eliminate the infectious process of the bone, we have two options; you can try to perform the duct treatment again or you can do an apicoectomy .

Apicoectomy, also known as  endodontic surgery, is a small surgical procedure, with which the aim is to eliminate the infectious process of the tooth and bone and to close (seal) the canal correctly so that the infection does not recur. It is a process by which the removal of the apical portion (the tip) of the root of a tooth, as well as the infected tissue involved, is carried out, through radiographs the tip of the root is located at the height of the gum and is created a “little window” through the gum and the bone to perform cleaning and filling the tip of the root.


Apicectomy is indicated in teeth with periapical processes such as:

  • The failure of root canal treatments (endodontics).
  • In teeth where the root canal treatment can not be repeated.
  • In teeth that present curves or in which the apex (or tip of the root) becomes inaccessible.
  • In teeth that have false ducts.
  • In ducts where an endodontic instrument has been fractured and housed.
  • Acute processes because it bleeds excessively and makes local anesthesia insufficient.
  • If the bone has been destroyed, reaching the middle zone of the root.
  • In case of massive destruction of the radicular portion.
  • If the affected area is very close to the maxillary sinus.

The surgical process consists of opening the gum at the level of the affected tooth, exposing the underlying bone of the piece and removing the affected tissue. Once this procedure is done, the apex of the root of the affected tooth is removed. Once the apex is removed, the obturator is placed, which is a sealant in the root canal called MTA, trioxide aggregate material, in the place where the apex of the tooth has been removed and the gum is sutured where the incision has been made. After a few months, the bone around the apex of the root will heal completely and the infection will have disappeared.


You must follow the medication guidelines indicated by the specialist, once at home you should apply cold on the cheek or jaw of the treated area intermittently during the following 12 hours, that is to say applying it for about 15 minutes and removing it from other 15 minutes At bedtime try to sleep with your head elevated with several pillows or cushions.

It is important that you rest and avoid doing physical activities. Above all, do not use the surrounding teeth to chew, try to maintain a soft and cold diet during the first 24 hours after the intervention. When brushing your teeth you should avoid brushing the affected area , do not lift your lips to see the area of ​​intervention. It is important that during the first 24 hours you do not smoke, or spit, that you avoid alcoholic beverages since they will not help the correct healing of the wound.

Coronary lengthening

Coronary lengthening surgery: in what cases is it done?

The crown lengthening is included within the specialty of Conservative Dentistry .

It is an operation whose purpose is to contour the gum, and even the bone, which are around a tooth so that it is more exposed and can be treated.

With this article, we will clear all doubts about coronary lengthening, explaining in what cases it is recommended and what are its benefits.

What is coronary lengthening?

Before focusing on the usefulness of the intervention, we will describe what it consists of.

As its name suggests, it is a process that allows increasing the length of the crown.

It can be done in one or several teeth , depending on what has motivated the operation and the purpose of it.

The main objective of coronary lengthening is only restorative and is performed on the lower or posterior teeth, which are the least visible in our mouth.

In this way, dental aesthetics are prevented from being affected , since the procedure reduces the gums a few millimeters and would be unbalanced with respect to the rest of the teeth.

It should not be confused with other types of exclusively aesthetic procedures, such as gingivectomy , in which the gum of the patient is cut slightly so that the tooth is more exposed and the smile is perfected.

When is coronary lengthening surgery necessary?

The intervention is carried out when there is some damage that extends to the inside of the gum .

Generally, this operation is used when there is a deep caries or a fracture that has exceeded the gingival margin .

This surgery is also indicated when the point on which a crown should be placed is below the gum.


In the case of caries, filling by composite would not have a correct seal , and with the passage of time filtering would occur with its consequent secondary decay .

With coronary lengthening, the orthodontist manages to get to the part of the tooth that is damaged and eliminate decay .

The process can be complicated if the patient is going to perform a coronary lengthening in a tooth with endodontics .

Why is it more difficult? The person, in this case, has no sensibility in that piece, so he will not be able to appreciate the appearance of a caries under the gum.

This situation is especially serious, because we must not forget that the ultimate consequence of caries is, in the most severe cases, tooth loss.

Fracture of a tooth

If we have suffered a strong dental trauma , it is possible that it ends up breaking.

In these cases, it is necessary for the dentist to see the end of the fracture in order to reconstruct the tooth correctly.

As with seals, the material with which the tooth is reconstructed will not be completely closed if there is any hidden fissure inside the gum.

Placement of a crown

To ensure the correct attachment of a crown it is necessary that the prosthesis surround the healthy tooth completely.

This remaining (natural) tooth of the person must have a height of at least 1.5 millimeters to prevent the crown from falling.

Even if it rests on a pin, if you do not have this part of the healthy tooth, leaks will occur .

Benefits of coronary lengthening

The main advantage offered by coronary lengthening surgery is that it allows saving a tooth that would otherwise have to be extracted and replaced with an implant.

As we have previously pointed out, the intervention is carried out when a restoration of the crown is necessary.

The coronary lengthening allows to remove and level the gums and bone in order to expose the tooth.

To ensure the correct sealing once the damage has been corrected (caries, fracture …), the periodontal tissue is adjusted so that there is at least one millimeter of healthy surface of the tooth outside the gum.

In addition, by increasing the length of the crown , the gum and bone are protected to prevent deterioration near the restoration.

The intervention

The first thing the periodontist does is remove the gum and lower the bone by the appropriate millimeters according to each case.

The entire bony surface is not reduced, but only in the area where coronary lengthening is necessary .

Once the damage has been corrected or the required intervention has been performed (seals, crown placement …), the gum is sutured .

How is the postoperative?

Coronary lengthening is a usual treatment in our clinic and, as we have explained previously, it is performed in most cases in the posterior part of the mouth .

The surgery is carried out by local anesthesia and lasts approximately between 20 and 25 minutes.

The patient will notice certain discomfort in the intervened area during the days following the intervention, so it is possible that the periodontist recommends the use of analgesics.

The postoperative period usually causes more pain if the coronary lengthening has been performed in areas of the lower arch.

In Ferrus&Bratos we will offer you a personalized treatment, and always carried out by a dentist specialized in his field .

In case you need a coronary lengthening, you will be attended by our periodontist professionals , who have the required technique to perform this type of surgery.

You can call us to arrange your appointment and we will give you a first diagnosis totally free.

Canine fenestration

The intervention is painless and fast

The inclusion of the canine occurs when instead of erupting at the right time (12-13 years) is retained in the palate , causing an alteration in the dentition, with permanence of the temporal canine.

To solve it, it is necessary to perform the fenestration of these pieces, whose objective is to eliminate the bone and the mucosa around the canine to release it , so that the crown of the same is visible and the orthodontist can perform the traction of the tooth.

The intervention is painless and fast , in Maxilodexeus we perform this technique in a minimally invasive way, under local anesthesia, to improve the postoperative period.

The canines, or fangs, are the teeth that most frequently present rash problems after the wisdom teeth, some do not erupt and remain included in the bone.

Are canines important?

Canines are very important teeth of our dental arch. They are very strong teeth that direct to the mouth in their movements and define the canine prominence that has functional and aesthetic repercussion, reason why it is fundamental to realize the fenestration to obtain its eruption.

What are the causes of the inclusion of canines?

The canines develop very high in the maxilla, and to get to erupt have to go a long way at a time when, in addition, the rest of the adjacent teeth already tend to have erupted. Certain local problems can hinder the path that the canine must travel to reach its position:

  • Supernumerary teeth
  • Lack of space due to premature tooth loss
  • Congenital absence of lateral incisors
  • Odontomas
  • Dental transpositions


Benefits of Canine Fenestration

With this treatment we can count on one of the most important teeth in our mouth and avoid the need to perform an extraction of the tooth retained in the future and its future replacement by some type of prosthesis or implant.

Having a tooth retained can lead to consequences such as:

  • Reabsorption of nearby teeth.
  • Cysts formation
  • Infection of pericoronary sac.
  • Lack of a tooth when it is lost in a temporary canine.


When should you opt for Canine Fenestration?

Generally the eruption of the canine teeth occurs around 13 years but it is advisable not to wait and perform an x-ray of the mouth (orthopantomography) at 8 or 9 years to check that the child has all the teeth and rule out obstacles to the rash .

How is the intervention performed?

At Maxilodexeus we take care of all the details, starting with the planning, where we analyze the angulation, position and the relation with the adjacent teeth to be able to carry out the fenestration safely, until the coordination with the orthodontist for its traction.

After a good planning, our experts work in a coordinated way to guarantee the best treatment . Our surgeons are responsible for making a window in the gum, which is known as fenestrar, to then remove the bone and mucosa that prevent the eruption of the tooth, making the crown visible.

The procedure lasts about 25 minutes, is completely painless and there is no edema or swelling in the postoperative period . After the intervention, it is necessary to make a soft diet during the first 2-3 days.

Once the stitches are removed from the fenestration, the orthodontist places a bracket on the tooth in order to pull it progressively until it takes its place in the dental arch.

Postoperative of Fenestration of canines

The recovery after Fenestration of canines is short and not very painful . Thanks to the use of minimally invasive techniques of Maxilodexeus, the postoperative period is shorter and more comfortable, only slight discomfort will be noticed after the intervention.

The swelling will be minimal, but it is possible to notice irritation on the palate during meals. To overcome more postoperatively, it is possible that a combination of anti-inflammatory and painkillers is prescribed.


Nobody is happy to hear that they have to do a tooth extraction. That they have to remove a tooth or any other tooth is painful and always generates some concern. That, not to mention that in Spain the price of these interventions  range between 22 and 250 € . But more than half of Spaniards must go through an exodomia at some point in their lives.

We have prepared this article where we inform you of everything you need to know about dental extractions: how long it takes to heal a tooth extraction, how long the pain of a tooth extraction lasts, what to eat, what to do to Do not get infected, healing time after your wisdom teeth are removed …

Many people worry about pain, but we have good news: there are modern anesthesia techniques that make the intervention much more bearable. You will feel some pain in the area after the extraction, but we have some tips that will help you recover quickly from an extraction.

But first of all, we think it’s important that you know the reasons why a dentist might recommend a tooth extraction:

  • Dental infection or severe decay .
  • Periodontal disease (in the gums).
  • Irreparable damage due to trauma (blows).
  • Dental impaction (in case of wisdom teeth).
  • Obtain the necessary space to realign the teeth with orthodontic appliances.
  • So that the dentures or dental implants manage to fit.



First, it is necessary to look at the main reason that leads your dentist to make the decision to remove the tooth. It is important that you be aware that it is an irreversible process , so be sure to clarify all the doubts you have before continuing. You can discuss your situation with your dentist or even ask for a second opinion .

Exodontia for damage or infection

A tooth infection can be a cause to extract a tooth. Thanks to recent dental advances, the removal of infected teeth is considered a last resort . Many cases can be treated simply with a dental filling (filling). Even if you developed a tooth abscess because of an infection , the root canal treatment can often preserve the tooth.

If the infection still persists, a tooth extraction, also called an extraction, will be necessary to stop its spread to other parts of the body through the bloodstream.

In case a large part of the tooth is lost due to the injury, your dentist will have the possibility of fitting a crown. Unfortunately, if there is not enough healthy tooth to support the reconstruction, they will have to be removed.

If you have an accident that loosens your teeth or if you feel severe pain, make an emergency visit to the dentist . You could carry out an emergency removal or prescribe another medication-based treatment.

Extraction of the wisdom tooth

The wisdom tooth is usually one of the main causes of tooth extractions.

The wisdom tooth – or third molar – is a problem for most people because our mouths simply do not have enough space for it to break through.

The fact that a tooth does not leave the gums correctly due to lack of space is known as ” impaction “. A tooth can be completely impacted – totally covered by the gum – or partially impacted – when only a part of the tooth has come out.

If a wisdom tooth is pushing the neighboring tooth, it can cause pain and even harm the healthy tooth. In this case, it would be best to remove the third molar.

Another common reason why the wisdom tooth should be removed are tooth decay or decay. Because these teeth are at the back of the mouth, they are usually difficult to clean. This means that they are more susceptible to infections. Even if the caries does not cause any pain, it is very likely to spread to the neighboring tooth if the third molar remains in its position.

Not everyone has the pack of 4 wisdom teeth. Some lucky ones do not have any. But if you have one or more of your third molars, the possibility of presenting complications at some point in your life are quite high.

Superior wisdom teeth are usually easier to extract than lower wisdom teeth. The reason? Their roots sometimes fuse, creating a smaller surface and a softer shape. In the same way, higher ones usually have three roots while lower ones have only two.

Excessive periodontal disease

Periodontitis – a severe manifestation of gum disease – causes the teeth to loosen . This is because the disease erodes the tissue and the bone that surrounds the root of the tooth, which in turn are responsible for fixing the tooth in place. If the disease has not progressed much, it is possible to treat it and save the tooth. In more advanced cases, extraction is usually the only option.

Extraction by dental alignment

Sometimes dental extractions are necessary before starting orthodontic treatment

Sometimes, people who wear braces- dental device-to correct dental malocclusion , you have to remove some teeth to release some space in the mouth.

Most likely you will be freed from the extraction but it will depend on the current state of your teeth as well as the type of brackets you choose. With Invisalign Invisible Brackets , for example, it is more common to create a slight widening between the teeth to create small spaces between each one.

We recommend that you first talk with your orthodontist to know if the treatment will require any dental extraction.


Routine of an exodontia

A simple dental extraction can be done in your dental clinic under local anesthesia. This means that you should not experience any pain but you will remain aware of what is happening around you.

There is a variety of dental instruments to extract teeth

The root of the tooth lodges in a deep hole of the gum: the dental alveolus. The ligaments hold the root of the tooth firmly in place giving it the bite force you are used to.

Very often, dentists use an instrument called an “elevator,” which fits under the tooth to loosen it. Alternatively, you may have to rock the tooth from side to side to enlarge the cavity. It is simply moving the wheel little by little so that it loosens and comes out more easily.

Once the tooth is loosened, the dentist can extract it directly with dental forceps . With anesthesia preventing any pain, you will only feel some pressure in your mouth during the process. In general, a simple extraction is done in just a few minutes.

If you feel very nervous about the procedure, ask your dentist if you can get an intravenous sedative. It will make you feel calm and relaxed, and you will not remember much of the procedure when the effects vanish.

Surgical extractions

Extraction of the wisdom tooth, especially in case of impaction, may require a more complicated surgical removal . The dentist or oral surgeon must cut inside the gum to access the tooth. Very long teeth are cut into smaller pieces to facilitate extraction.

Surgical extractions of a tooth can be performed under local anesthesia, but more complex cases will require general anesthesia. In this case, the removal is done by a dental surgeon in a hospital after they completely put you to sleep. General anesthesia is also used for infant extractions, or when several teeth have to be removed at the same time.

Another reason to need a surgical procedure instead of a simple extraction is when there is no tooth surface on the gum line. It can be due to a caries in a very advanced state or to a blow. In this case, the dentist must cut the gum to access the remaining root.

When the teeth are cracked or fractured the extraction is usually more complicated due to the risk of breakage.

Immediate aftercare of exodontia

Immediately after the extraction, the dentist cleans the empty dental socket and makes sure that no fragments of bone or tissue remain. The dentist will press down on the sides of the alveolus to suppress bleeding and keep the jaw bone in the correct way.

Stitches in a recent extraction

It is at this point that your dentist will put points on the gum, if necessary. It is normal to receive points after a surgical incision, and sometimes also after a regular extraction. Dentists sometimes use a self-dissolving material that disappears on its own after a week or more.

Finally, the medical staff will give you a piece of folded gauze for you to bite. This absorbs blood and puts pressure on the extraction site. You will probably also receive an ice pack to minimize swelling. Carefully follow any instructions that your dentist gives you in this regard, as it will favor your recovery.

Does removing a tooth hurt?

As we have already mentioned, the dentist will anestasize the local area. You will feel pressure, but not pain . The injection to administer the anesthesia can be a little painful, but your dentist can use a special anesthetic gel to reduce the pain quite a lot.

In case you start to feel pinches or pain, notify your dentist immediately. If you are anxious about feeling pain during the procedure, arrange a signal with your dentist that you can use to tell him or her that you need to talk.

It is more common to feel some discomfort or pain after the extraction, once the anesthesia loses its effect. You can read more about how to deal with this below, in the recovery section.


One of the things that people care about most about tooth extraction is healing and recovery. Your dentist will tell you what to do after a tooth or tooth is removed. You should know that the recovery process depends on the type of intervention and the position of the tooth , but you must follow the dentist’s instructions to the letter. We leave some general information and advice so you know what to expect when you face an extraction.

How long does it take to cure a tooth extraction?

After the procedure, a blood clot will form in the empty socket. It is important to do everything you can to keep it in place. If the clot dissolves, the alveolus will be exposed, which is very painful. This is called “dry socket” and requires additional dental care.

In simple cases, the healing time of a tooth extraction is 7 to 10 days . Then the tissue of the gum is quite recovered and the stitches can be removed, if they do not fall on their own. In about two weeks, the smaller alveoli will be completely cured.

How long does it take to cure a wisdom tooth extraction?

The recovery of a third molar extraction may be a bit longer, especially if the molar was impacted and had to be removed surgically. This is simply because the molar extraction wound is longer and takes longer to heal completely. Especially the part that is not seen. Under the surface, it takes about 6 to 8 months for the jawbone to grow back and fill in the hole left by the tooth.

How long does the pain last after a tooth extraction?

It is normal to feel some discomfort, inflammation or pain after a tooth extraction. Your dentist will prescribe analgesics to relieve it. I may also recommend other products or medications that you consider appropriate.

The area around the alveolus is probably sensitive and you may experience some swelling in your face. It should decrease in 2 or 3 days.

If you continue to experience pain, or if you suddenly notice that it becomes more intense days later, contact your dentist immediately as you may have an infection.

Tips to recover quickly from an extraction

To speed up the recovery process it is important to give yourself proper care after dental extraction. Thus, you can return to normal as soon as possible.

In the first 24 hours after tooth extraction you should:

  • Apply a gauze as we have explained.
  • Inform your dentist if the bleeding does not decrease.
  • Avoid rigorous rinsing with water or mouthwash.
  • Avoid brushing your teeth near the extraction site.
  • Resist the temptation to touch the site with your tongue or fingers.
  • Avoid hot foods and drinks because heat may dissolve the blood clot.
  • Avoid smoking or drinking through sorbets, the action of sucking can pull the clot.
  • Keep your head elevated when you are lying down.
  • Take it easy and avoid strenuous activities.

How many days of rest after removing a tooth?

Consider taking a day or two away from work so that your body has time to rest. 24 hours after the extraction you can use salt water to clean yourself. Dissolve half a teaspoon of salt in a cup of water and rinse your mouth.

It is recommended that during a few days you opt for soft foods and chew on the opposite side of the mouth. If you have had multiple extractions in different areas, your dentist may recommend a liquid diet.

You should keep these precautions for more than a week after a surgical removal.

Continue drinking enough water so that your body stays hydrated during the healing process. just remember not to use a sorbet.

Once you have recovered, try to maintain a good oral hygiene to reduce the chances that you need another tooth extraction or some other type of treatment in the future.


If you need a dental extraction -particularly one from the front-, you will soon be thinking about the options you have to replace it. The three main options are:

  • Dentures (false teeth).
  • A bridge.
  • A dental implant

Consider replacing the extracted tooth with an implant

Dental implants

They are the most permanent option and also the most similar to a natural tooth.

The titanium implant is inserted into the mandibular bone and an artificial dental crown is adhered on top. The bone fuses with the implant and that minimizes bone loss.

But implants are the most expensive options: they cost around € 1800 for each dental implant and crown. Fortunately, there are ways to save money on the treatment to make the implants more profitable.


Bridges and dentures are types of dentures that adhere to the surface of the gum. A bridge is permanently fixed in place while a denture is removable and placed .

Both serve as long-term solutions for tooth loss. They are cheaper than implants, but come with the risk of bone loss over time.

You may have a temporary prosthesis if one of your front teeth is removed. Talk to your dentist to determine what options are available to you, and how much they will cost you.

Thanks to modern dentistry there are different ways to restore your smile.


The gingivectomy is the removal of gum tissue (gingival) through surgery. Gingivoplasty is a type of gum surgery used to reshape healthy gum tissue around teeth.  Periodontologists usually perform two types of surgery. These dentists specialize in treating gums and other structures that support the teeth.

In which case should one undergo a gingivectomy or gingivoplasty?

Gingivoplasty is the operation of changing the shape of the gums when the gums have an unusual shape or when they have not formed normally. Causes may include genes, illness or trauma to the person. A multi-bag orthodontic treatment can cause gingival hyperplasiaand, in this case, will require gingivectomy and gingivoplasty.Gingivoplasty remodels the gums to make them more natural . This technique is often performed alone but can be done during or after a gingivectomy. Gingivoplasty can also be performed with a gum graft. This type of surgery adds tissue to the gums in cases such as gingival recession, the bare tooth becomes sensitive, then proceed to a gum transplant.

Gingivectomy has been developed to treat periodontaldisease. Today, it is more commonly used to remove a piece of gum that has proliferated or to improve the appearance of the gums. We may have to reduce the gums in two cases

  • Periodontal pockets have formed between the teeth and gums. The gum is no longer adherent to the neck of the tooth. The gum does not play its hermetic role anymore and these pockets can trap food pieces, and harbour colonies of bacteria, and it is difficult to keep the area clean. If the pockets only involve soft tissues, they can be removed by a gingivectomy.
  • There is too much gum tissue around the teeth. In cases of gingival hypertrophy, there is often a cause such as taking medication, for example nifedipine, cyclosporine and more particularly phenytoin (Dihydan). do not like this proliferation of gum that hides part of the outer surface of their teeth. It can also make teeth and gums difficult to clean. In severe cases, this condition can interfere with chewing and speech. Excessive growth of gum tissue can be caused by certain medications. Sometimes there is no apparent cause.

Conditions for performing a gingivectomy or gingivoplasty

Before a gingivectomy or gingivoplasty, you must receive a complete dental cleaning. This cleaning removes bacteria (plaque) and calculus (calculus) from the pockets around the teeth. Your periodontologist will explain in detail how to take care of your teeth and gums after surgery.

How to proceed to a gingivectomy or gingivoplasty?

Before or the other procedure, you will receive a local anaesthetic to anesthetize your gums. A gingivectomy can take from a few minutes to over an hour. The length of the intervention time depends on the amount of tissue removed.Gingivoplasty is usually done in minutes.

These two surgical procedures are usually performed with scalpels. They can also be done with electrosurgery or lasers. Your periodontologist may use special tools that have been designed for gingivectomies.

Operative suites

After either technique, a periodontal dressing will be placed on your gums to protect the wound for a week to 10 days. A periodontal dressing is soft and has the texture of play dough. During this time, you will need to follow a relatively mild diet and avoid spicy and crunchy foods. Your dentist may prescribe analgesics for pain and antiseptic mouthwash.

It is very important to keep your mouth clean while the healing phase. You will not have to brush your teeth in the surgical area while the periodontal dressing is in place. You will be able to brush the rest of your teeth by carefully avoiding the operated area.

If the surgical dressing comes off, you can brush the area gently. Healing tissues can bleed when you brush. Your gums will begin to recover a normal appearance within three to four weeks. It can take two to three months for the tissue to heal completely.

What are the risks of these operations?

There are no major risks for both procedures. Infection and prolonged bleeding may occur. However, both are rare.The affected area may ooze for the first 24 to 48 hours. After that, he should not bleed a lot, if at all.

In which cases should I call my periodontologist?

  • If you have unwanted bleeding that you cannot control.
  • If you have excessive pain that does not stop with the analgesics it has prescribed
  • If you think the area may be infected.
  • If you have a lot of abnormal swelling of the operated area.
  • If the periodontal dressing becomes loose or comes off in a few days.

Gum Graft

The recession of the gums not only affects the aesthetics of your smile, but it can also have a negative impact on the stability of the teeth or on the possible discomfort that can result from showing a greater amount of tooth surface.

In case a patient acknowledges this retraction, the most appropriate treatment is a gum graft.

In this article, we will tell you what this procedure consists of, what care you should take into account after having submitted to it and what benefits it has for your mouth.

Why are the gums retracted?

The gums play a fundamental role for the health and functionality of our mouth : they serve as support for the dental pieces and, in addition, protect the root of the tooth from the action of pathogens and external stimuli.

However, its stability can be compromised by a series of causes, such as:

  • Periodontal disease -gingivitis or periodontitis-, which attacks the supporting tissues of the mouth.
  • A too aggressive brushing
  • Bad habits such as, for example, smoking

In addition, other factors must be taken into account, such as hormonal processes – gum health is more sensitive during pregnancy – or a more advanced age.

Gum recession involves a loss of tissue around the tooth , gradually exposing a greater amount of tooth surface.

In the most advanced cases, this retraction may have its reach in the bone on which the pieces are supported, causing dental mobility and affecting the stability of the same.

Due precisely to the gradualness of this process, the patient is not conscious until this recession is in a more advanced state . That is, when this involves certain discomforts such as, for example, a greater tooth sensitivity or compromises the aesthetics of the smile-a greater amount of tooth surface is shown.

Given this situation of gingival recession, the performance of a gum graft will be indicated.

What is a gum graft?

It is a microsurgery whose objective is to recover the damaged gum and avoid the possible future problems that could arise from this retraction.

How is a gum graft done?

Gum grafting is a minimally invasive surgical technique. It consists in the taking of soft tissue -generally from the palate of the patient itself- that, subsequently, the surgeon will place in the area where the tooth or implant has been left without protection.

Depending on the degree of severity of the recession and the state of the patient’s gums, we can distinguish three different types of graft .

Types of gum graft

It will be the surgeon who, after evaluating the state of the gums, determines the need to approach the procedure in one way or another.

The pediculated gingival graft consists in the extraction of tissue from the area of ​​the gum next to the unprotected tooth. This tissue sample, known as a pedicle, is partially cut and sewn into the area adjacent to the affected piece.

However, sometimes there is not enough mass in the gums to perform this type of intervention. It is then when the surgeon resorts to the tissue present in the palate .

Within the techniques that resort to the extraction of the mass present in this area, we can distinguish two types of graft:

  • On the one hand, the connective tissue graft consists in the separation and selection of subepithelial tissue to protect the damaged area. On the contrary, the rest of the sample taken will be reintroduced in its place of origin.
  • On the other hand, the free gingival graft takes part of the palatal tissue to place it, in its entirety, in the area to be repaired. This procedure is common in those cases in which the patient needs to increase the thickness and, therefore, the consistency of the gums.

Finally, in those occasions in which the mass can not be taken from any of the two areas mentioned above, the specialist may resort to a tissue bank .

Is it painful to have a gum graft?

The gum graft is a minimally invasive technique that is performed under local anesthesia, so that its effect mitigates any discomfort that the patient may suffer during treatment. Therefore, we can say that the gum graft, as such, does not hurt .

But, also, for those patients suffering from odontophobia – fear of the dentist – at Ferrus&Bratos we offer you the choice of the conscious sedation system .

Thanks to the same, the patient will remain in a state of partial consciousness during the entire treatment, avoiding any possible feeling of anxiety that could suffer during the intervention.

However, throughout the healing process it is possible that the patient feels slight discomfort or acknowledges the appearance of small traumatisms, whose incidence will be reduced provided that it respects the guidelines of the specialist.

Tips to follow during the postoperative period of the gum graft

If you have recently had a gum graft, or are going to do it in the near future, this interests you.

Our team of surgeons affirms that there is a series of recommendations that, following them the days after the intervention, have a very favorable repercussion at the time of mitigating the discomforts and avoiding possible complications. Some of them are the following:

  • Use the anti-inflammatory medication prescribed by the specialist who has addressed your case to relieve postoperative discomfort. Generally, this shot is advised during the 3 or 4 days after the intervention.
  • Apply ice in the area during the 4 or 5 hours after surgery to reduce inflammation of the area and prevent the occurrence of possible trauma.
  • Avoid the practice of sports or activities that involve any type of physical effort during the week following the operation, so that you can not suffer a blow to the area.
  • Include in your diet soft foods and, generally, tempered or cold . Do not consume those that may involve a chewing effort.
  • Follow correct oral hygiene routines . In the 15 days following the procedure, you can rinse with chlorhexidine. Remember that you must do them in a delicate way so as not to compromise the stability of the graft performed.
  • Avoid the consumption of tobacco . Smoking notably hampers the healing process.


What benefits does the gum graft have for your mouth?

The gum graft involves minimal risks and discomfort compared to the benefits it can have for the health of your mouth.

First, this procedure covers the root of the tooth-or implant-that has been exposed. In this way, it again has the natural protection offered by the gum against dental plaque and bacteria, improving dental health.

For this reason, we can say that it prevents the affection of caries and the advance of periodontal diseases . You must bear in mind that these are motivated by the action of the bacterial plaque, generally due to a little exhaustive brushing.

The plaque tends to accumulate, in addition, in the area that presents this retraction, because we incidimos less in the brushing -produces greater discomfort and, sometimes, bleeding-.

The gum graft is the brake to advance the loss of tissue , and reduces the chances of suffering in future dental mobility or the loss of any of the pieces.

In addition, by protecting an area of ​​the tooth that was previously exposed to foreign stimuli, reduces the discomfort derived from tooth sensitivity .

Finally, you should not forget that the gum graft is also performed for aesthetic purposes . Thanks to it, the initial beauty of the smile is recovered, maintaining harmony with the rest of the gum.

If you have any questions regarding this procedure or would like to request an appointment with our specialists so that they can assess your case in the clinic, we invite you to call us. We are waiting for you!