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Initial Periodontal Therapy Osseous Surgery Periodontal Plastic Surgery Reconstructive Surgery Maintenance

Initial Periodontal Therapy

Oral Hygiene Coaching

     Plaque is the primary cause of periodontal disease. Thorough daily removal of plaque is crucial in your return to optimal health. We demonstrate and help you with the various aids that, used properly, will reduce inflammation and redness of your gums. We will give you a supply of these aids through your initial therapy and surgery.

Scaling and Root Planing

     A procedure in which the tartar or calculus (hard toxic deposits on teeth) are removed. First, an ultrasonic instrument is used, followed by scaling with instruments to smooth the tooth root. This procedure is usually done in two appointments, and local anesthetic is given.

     During Initial Therapy, vitamin recommendations and nutritional counseling are discussed. Support of the immune system is also key in healing and maintenance of health. Smoking cessation programs will also be recommended should you be interested.

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Osseous Surgery

     A procedure that treats the affected pocket and underlying bone and bony defects caused by periodontal disease.  Pockets are decreased, thereby giving you complete access to clean all the teeth to effectively stop the progression of jaw bone destruction. Procedures done in combination with osseous surgery are:

1) Bone Grafting:  In certain "vertical" defects that have a wall of bone parallel to the tooth, bone graft material can be used to fill the defect to strengthen the tooth so it can be saved. This bone is sterilized, demineralized, and stripped of protein. It is obtained from a bone bank in the form of particles. The bone graft stimulates new bone growth, benefitting patients by restoring stability to their teeth.

2) Guided Tissue Regeneration:  A technique which uses a synthetic material to cover a bony defect or a bone graft to regenerate lost jaw bone to save teeth.

3) Emdogain:  An enamel protein with growth factors that regenerates lost jaw bone and gum tissue -- can be used alone or in combination with bone grafts.

4) Root Resection:  When a molar root has lost bone around it and the other root or roots are still healthy, a root may be removed in order to save the affected tooth. After healing, the remained tooth will require a root canal and likely a new crown.

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Periodontal Plastic Surgery

Connective Tissue Grafts

     A procedure where gum tissue is transferred from the roof of the mouth and placed under existing gum tissue and also to cover recession areas.

Free Gingival Grafts

     A procedure where gum tissue is transferred from the roof of the mouth to below the gum line to prevent further recession.

Cosmetic Crown Lengthening

     A procedure which raises the gum line to lengthen the decayed or broken tooth, so your dentist can make a crown or bridge that can grip tightly and fit well.

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Reconstructive Surgery

Ridge Augmentation

     A procedure done to restore normal contours to gum tissue where a tooth or teeth have been lost. This procedure is done to ensure proper contours of fixed bridge work or implants. It is accomplished by implanting soft gum tissue from the roof of the mouth or a bone graft to the area which has collapsed from a previous tooth removal.

Site Preservation

     For teeth that must be removed due to severe periodontal disease or fracture, this procedure is done to prevent the resulting tooth socket from collapsing. The socket is cleaned out and a bone graft is placed, with membrane used to cover it. The area is allowed to heal, and a bridge or implant is then used to replace the lost tooth.

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Maintenance

     After initial and surgical treatment is completed, maintenance follows. Also called Supportive Periodontal Therapy, this "periodontal cleaning" is normally completed every three months and is usually done on an alternating basis between our office and your general dentist. Your medical history is updated, all the "pockets" are charted and compared with your last visit, and your teeth are scaled and polished thoroughly. Any new disease or reinfection is monitored, diagnosed, and treatment recommended if necessary. This treatment, as well as excellent home care, is essential in the maintenance of your periodontal condition.

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