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Periodontics/Gingivectomy suggested

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X-Ray
X-Ray  
Hello,
I am a 32 year old male with complaint of swollen gums for about 10 years now. After a set of cleaning procedures over the past few years, the bleeding has decreased significantly. I now have a dull pain while chewing on tooth number 12 (Upper Left posterior tooth). My dentist says there are no issues in the X-Ray (Attached) and has suggested a Gingivectomy. Another dentist has suggested a root planning. I am confused on what to do.

One dentist says there is bone loss, where as the other one says there is minimal bone loss. Can you please provide your expert views please.

Thanks!!

Answer
The tooth 12 is not very posterior, it is located behind the left upper canine tooth. But you have pain on the upper left side and I'll try to address that.

This is what I see on the X-ray:

There is slight periodontal bone loss around the wisdom teeth on the right side, both upper and lower (01 and 32) and between teeth 02 and 03 and 14 and 15 (the two other upper molars on both sides). Otherwise, periodontal bone loss is quite minimal. There Are also big cavities in the wisdom teeth on the right side and on tooth 31 (the tooth in front of the lower right wisdom tooth). Other cavities are not visible. The left upper wisdom tooth (16) has been removed and, as a result, the left lower wisdom tooth (17) has moved up and therefore interferes with how the teeth make contact with each other when you chew (occlusal interference).

The details of tooth 12 are not clearly visible in the x-ray due to it's location slightly outside the plane of the x-ray, it seems, however, to be fine.

It is not possible to judge the presence or absence of gingivitis from an x-ray. You tell me, however, that the gums bleed less than before. From this I understand that they still do bleed some. That bleeding should be treated.

After treating the gum disease, I would recommend first having the remaining three wisdom teeth removed. Thereafter, the cavity in tooth 31 should be treated. Finally, the occlusion should be checked for possible remaining interferences.

After all this has been done and the extraction wounds have healed, it is easier to judge if there are some additional problems in tooth 12 (such as a crack).

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Marketta Hormia, DDS, PhD

Expertise

I am a periodontist living and working in Helsinki, the capital of Finland, where I have my private dental practice. I am an international member of the American Academy of Periodontology. I have a Ph.D degree and a long background in research and teaching at the University of Helsinki and at the University of Turku, Finland. I function as an adjunct Professor at these Universities. I have also worked as a visiting scientist at the Scripps Clinic and research Foundation, la Jolla, CA. I can answer any question in the fields of dentistry and periodontics.

Experience

Private practitioner in Helsinki, Finland over 20 years. Former researcher and teacher at two Finnish Universities.

Organizations
The Finnish Society of Dentists, Division of Periodontology, American academy of Periodontology

Publications
Over 30 scientific research articles published in peer-reviewed international scientific journals (can be found on PubMed)

Education/Credentials
D.D.S., Ph.D, Specialist in Periodontology. Adjunct Professor.

Awards and Honors
Visiting Scientist at the Scripps Research Foundation, San Diego, California, 1992-1994. NIH grant

Past/Present Clients
Dental patients, national and international. All kinds of dental, oral and temporomandibular joint problems

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