- Periodontal or Gum Disease Treatment:
Periodontal disease, also known as gum disease, is a serious inflammatory disorder that, left untreated, can lead to tooth loss. The word periodontal literally means "around the tooth." Periodontal disease is a chronic inflammatory disease that affects the gums and bone supporting the teeth. Periodontal disease can affect one tooth or many teeth. It begins when the bacteria in plaque (the sticky, colorless film that constantly forms on your teeth) causes the gums to become inflamed. If left untreated, this inflammation can cause the gums and supporting bone structure to deteriorate. This can lead to gum recession or even tooth loss. In addition, research has shown that gum disease may be associated with other diseases, such as diabetes and heart disease.
Periodontal treatment aims to remove the bacterial plaque and generally includes 2 approaches: Non surgical and Surgical treatment.
- SCALING AND ROOT PLANING (Non- Surgical Deep Cleaning)
Scaling and root planing is a careful cleaning of the root surfaces to remove plaque and calculus [tartar] from deep periodontal pockets and to smooth the tooth root to remove bacterial toxins. Scaling and root planing is sometimes followed by adjunctive therapy such as local delivery antimicrobials, systemic antibiotics, and laser bacterial reduction, as needed on a case-by-case basis. After this type of treatment, the majority of patients will require ongoing periodontal maintenance therapy to sustain health.
- PERIODONTAL POCKET REDUCTION PROCEDURES (Surgical)
During this procedure, the gum tissue will be fold back to form a flap which gives direct access and visibility of the deep pockets, then will remove the disease-causing bacteria before securing the tissue into place. In some cases, irregular surfaces of the damaged bone are smoothed to limit areas where disease-causing bacteria can hide. This allows the gum tissue to better reattach to healthy bone.
These procedures which might be done as part of the surgical periodontal treatment, can reverse some of the damage by regenerating lost bone and tissue. During this procedure, after opening the flap and removing the bacterial plaque and other local irritants, membranes (filters), bone grafts or tissue-stimulating proteins can be used to encourage body's natural ability to regenerate bone and tissue.
- Soft Tissue Grafting or Gum Grafting:
Gum grafts can be used to cover roots or develop gum tissue where absent due to excessive gingival recession. This can be done for one tooth or several teeth to even your gum line and reduce sensitivity. The purpose of these procedures is either to augment/thicken the amount of limited gum or for covering the exposed root surfaces or sometimes both purposes. A gum graft can reduce further recession and bone loss. In some cases, it can cover exposed roots to protect them from decay. This may reduce tooth sensitivity and improve esthetics of your smile.
For increasing the amount of limited or absent gum, usually a piece of graft from the roof of the mouth will be used. For root coverage purpose there's two options available: patient's own tissue (usually from the palate) or sterile ready to use graft material (from tissue bank or from animal sources).
- Crown Lengthening
Crown lengthening is a surgical treatment that involves removing excess gum tissue, and possibly some bone around the teeth to make them longer. The purpose of this procedure is either to provide more tooth substance for dentist to put a crown/restoration on or for cosmetic/esthetic reasons.
During the cosmetic crown lengthening procedure, excess gum and bone tissue is reshaped to expose more of the natural tooth. This can be done to one tooth, to even your gum line, or to several teeth to expose a natural, broad smile. This is the right treatment option to correct some of the gummy smile cases which teeth are showing smaller and shorter.
Sometimes the tooth is decayed, broken below the gum line, or has insufficient tooth structure for a restoration, such as a crown or bridge. Crown lengthening adjusts the gum and bone level to expose more of the tooth so it can be restored.
- Tooth Removal and Ridge Preservation:
Maintaining a wide and uniform bone is critical for successful placement of dental implant. Also some physiologic bone resorption/remodeling will happen after tooth extraction which along with prior bone loss can result in limited bone amount. Therefore bone graft or guided bone regeneration is highly recommended after tooth removal. Hopeless tooth will be removed gently without trauma, bone graft will be placed in the clean socket and covered with a protective membrane to prevent further bone resorption and also to create more bone.
- Dental Implants:
Dental implants nowadays are the best option to replace single or multiple missing teeth. A dental implant is an artificial screw-shaped root (pure titanium) that is placed into your jaw to hold a replacement tooth or bridge. Dental implants may be an option for people who have lost a single tooth or multiple teeth due to periodontal disease, an injury, or some other reason. For fully edentulous case, implants are the best option for better retention and stability of complete denture. Implant site preparation will be done with sequence drilling. After implant placed more bone graft/membrane might be needed based on the case.
- Sinus Augmentation
A key to implant success is the quantity and quality of the bone where the implant is to be placed. The upper back jaw has traditionally been one of the most difficult areas to successfully place dental implants due to insufficient bone quantity and quality and the close proximity to the sinus. Sinus augmentation can help correct this problem by raising the sinus floor and developing bone for the placement of dental implants.
Ridge Augmentation/ Modification
Deformities in the upper or lower jaw can leave you with inadequate bone in which to place dental implants. This defect may have been caused by periodontal disease, wearing dentures, developmental defects, injury or trauma. Not only does this deformity cause problems in placing the implant, it can also cause an unattractive indentation in the jaw line near the missing teeth that may be difficult to clean and maintain.
To correct the problem, the gum is lifted away from the ridge to expose the bony defect. The defect is then filled with bone or bone substitute to build up the ridge and will be covered with membrane. Depending on individual needs, the bone usually will be allowed to develop for about 6 to 12 months before implants can be placed. In some cases, the implant can be placed at the same time the ridge is modified.
Ridge modification has been shown to greatly improve appearance and increase the chances for successful implants that can last for years to come. Ridge modification can enhance restorative success both aesthetically and functionally.