Periodontics
Bone Regeneration

Tooth loss occurs for many reasons, including: dental decay, root canal problems, fractures, periodontal disease, and trauma. Additionally, in some cases teeth never develop. As a result of tooth loss, the bone melts away. If there is inadequate bone to support surrounding teeth and future possible dental implant(s), bone grafting materials are used to rebuild and regenerate the bone. This process aims to provide sufficient bone quantity and quality for implant placements and supporting tooth structure.

Functional Crown Lengthening

Decay can frequently be found below the gum line. In order to gain access to the decay, it is necessary to reduce some of the bone surrounding the area of decay so the gum tissue can be positioned either higher up or lower down on the tooth making access to repair decay feasible. In other circumstances, the tooth may fracture below the gum line. Often the tooth requires a crown (cap) to cover over the fracture line. In order for the crown to fit over the fracture line, it is necessary to raise or lower the gum and reshape the bone accordingly so that the fracture line now becomes visible above the gum. The tooth is now ready for a crown (cap). When smiling, ideally there should be a display of upper teeth and a slight amount of gum displayed as well. In many circumstances there is an excessive amount of gum displayed (this is known as a gummy smile). In order to reduce the gum display so that there can be an ideal amount of tooth and gum showing, it is necessary to move both the gum and bone higher up on the teeth. The bone is gently sculpted to create room for the gum tissue to be ideally positioned. Hence the correct proportions of the teeth and gum are now visible.

Sinus Lift

In the back of the upper jaw bone, dental implants are frequently needed. In order for a dental implant to be successful in this area of the mouth, there must be sufficient bone height and width to connect (integrate) to the dental implant. When the upper back teeth are lost and not replaced, the sinus cavity becomes enlarged destroying any bone that is left behind. This very large sinus is like a "giant air pocket" and not capable of supporting an implant. A procedure known as sinus grafting (sinus lift) is performed to create bone that will ultimately hold the implants within the sinus. Sinus grafting is an extremely common form of bone grafting.

Gum Flap Surgery

When deep pockets between teeth and gums (6 millimeters or deeper) are present, it is difficult for a dentist to thoroughly remove the plaque and tartar. Gum flap surgery is a procedure where the gum flap is lifted away from the tooth. Diseased tissue and sometimes bone is removed. The rough surfaces of the tooth are then smoothed by root planing. The area is medicated and the gum flap is replaced and sutured allowing the bone and gum tissue to heal. One of the goals of gum flap surgery is to reduce the depth of the periodontal pockets to make them easier to keep clean.

Gum Lift

A gum lift may be performed to create a more even gum line. Patients with a gummy smile can quickly and safely have unwanted tissue removed, thus exposing more tooth to shape a more attractive smile.

Soft Tissue Grafting
Soft Tissue Grafting

Root exposure resulting from gingival tissue recession may pose multiple problems for patients:
- Undesirable Aesthetics
- Root Sensitivity
- Impaired Oral Hygiene
- Increased Caries Susceptibility
- Teeth May Become Loose


A gingival tissue graft will restore the proper gum tissue structure around the tooth.

Frenectomy

If a patient has an excess amount of tissue that connects the lower and upper lips to the jaw and gum line, a frenectomy procedure is performed to remove the excess tissue. A frenectomy is either performed inside the middle of the upper lip, which is called a labial frenectomy, or under the tongue, called a lingual frenectomy. Frenectomy is a very common dental procedure in the dental world and is performed both on children and adults.

Ridge Regeneration

When a tooth is lost and not immediately replaced, the bone reacts to this event by 'shrinking back'. The bone becomes thinner from a width perspective and the bone height is frequently reduced. This process is known as bone resorption. In order to place implants, it is necessary to rebuild the bone width and height through regenerative surgical therapy. Bone grafting of the ridge is almost always required to enable accurate placement of dental implants. The grafting is completed utilizing tissue bank and/or synthetic bone particles combined with collagen membranes. It is a highly predictable procedure.

PRF (Platelet Rich Fibrin)

PRF (platelet rich fibrin) is one of our major assets of our implant practice. The PRF Kit (inventor Joseph Choukroun MD ) spins down blood and harvests the platelets and leukocytes containing fibrin fraction. The PRF Kit can produce thick membranes of fibrin, rich in growth factors in a chair procedure stimulating bone and soft tissue growth after implant and periodontal surgeries.

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